Board of Health 2012 Annual Report

Current Health Department Staff

WIC Environmental Nursing Mary Smith Larry Hanna, R.S. Gwen Shafer, RN Amy Gabriel Steve Deeter, R.S. Diana Stover, RN Erin Connolly Deb Kilbarger, R.S. Jenny Grove, RN Lucinda Robinson Jen Valen ne, R.S. Pat Garre , RN Debbie Smith Dennis Oliver Merillee Taylor, RN Kay Higgins Sean Stephenson, SIT Sheri Johnson Kerri McReynolds, SIT Administra on Jerry Tulga, SIT Fiscal Larry Hanna, R.S. Kelly Donley Paule e Tiller Kathie Whitlock Cindy Sharpe Paule a Krieger Vital Sta s cs Jane McGuire Health Commissioner/Medical Director Cindy Sharpe Dr. Mark Aebi Fairfield Department of Health - 1587 Granville Pike, Lancaster, Ohio 43130 - (740) 652-2800 - www.myfdh.org

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2012 Fairfield County Health Department Funds

Funds Revenue Expenses Balance

General Fund 745,451.40 573,406.88 171,952.52

Parks/ Pools 26,051.79 36,281.91 (10,230.12)

Safe Kids 408.04 8,931.16 (8,523.12)

Solid Waste (CFLP) 25,436.02 33,560.76 (8,124.76)

Injury Preven on 62,840.21 62,574.33 265.88

Food Service 192,913.97 186,794.98 6,118.99

C & DD 118,928.01 161,205.22 (42,277.21)

Water 71,653.19 51,326.34 20,326.85

Plumbing 47,221.15 38,921.35 8,299.80

Immuniza ons 104,110.60 113,287.58 (9,176.98)

Sewage 62,534.66 106,917.93 (44,383.27)

PHEP/ CRI 119,418.95 143,330.04 (23,911.09)

CFHS 35,245.95 40,039.42 (4,793.47)

Help Me Grow 32,320.79 32,049.92 270.87

WIC 264,384.72 335,780.36 (71,395.64)

Vital Sta s cs 210,415.15 240,890.95 (30,475.80)

Totals 2,119,334.60 2,165,388.93 (46,054.32)

Dr. Aebi, Health Commissioner and Medical Director

Larry Hanna, R.S., Ac ng Administrator & Kathie Whitlock, Administra ve Assistant

2012 Board of Health Members

Dave Pe y, President - top le

Darryl Koop, MD - top right

Jim Massey - center

Charlie Engen - bo om le

Tina Childers - bo om right

Paule e Tiller & Paule a Krieger - Fiscal Office

Nega ve balance offset by $430,461.06 carryover from 2011

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Part of protec ng our county’s health is working to make sure that the water we drink, the food we eat, and the places we live won’t endanger our health now or the health of future genera ons. Restaurants and retail food establishments are inspected to prevent the occurrence of food-borne illness. Residen al and commercial sew-age treatment systems are inspected to protect public water supplies. Private water systems are inspected to ensure residents have safe drinking water. Other pro-grams include public swimming pools, school inspec ons, animal bite inves ga ons, public health nuisances, campgrounds, solid waste inves ga ons, ta oo and body piercing facility inspec ons, and the plumbing program.

Environmental Division

Front row: Deb Kilbarger, Cindy Sharpe, Jen Valen ne, Kerri McReynolds, Kelly Donley. Back row: Jerry Tulga, Steve Deeter, Larry Hanna, Sean Stephenson, Dennis Oliver.

Food Protec on Program The Food Protec on Program works to ensure the safety of food prepared, served and sold in Fairfield County through educa on, monitoring and enforcement. Licenses Inspec ons Food Service and Retail Food 430 1107 Mobile Food 73 73 Temporary Food Licenses 127 127 Vending Food Licenses 52 32

Sewage Program Registered sanitarians inspect residen al and commercial sewage systems to be sure that the waste these systems generate does not pollute our streams or the water sup-ply that we count on for drinking water. Sanitarians also review property lots and the plans developed prior to building so that the sep c systems installed on these lots protect the environment. Sewage Treatment System Permits 84 Lot Splits 22 Haulers/ Pumpers Registered 26 STS Installers Registered 35 STS Service Providers Registered 16 STS Designers Registered 9

Private Water Systems The Private Water Systems program is a state mandated program which includes wells, springs, cisterns, and ponds that are used as a potable water supply. Sanitarians collect a water sample from each well permi ed to ensure a safe potable water supply. All well drillers are registered by the Ohio Department of Health (ODH) and are inspected annually for renewal of licenses. Private Water System Permits Issued 132 Private Water Systems Sampled 236

Public Swimming Pools/ Spas The Fairfield Department of Health inspects public swimming pools, spas, and special use pools to prevent injury, minimize the poten al for disease transmission, and provide a safe and healthy aqua c recrea onal environment. Licensed Pools/ Spas 48 Inspec ons Performed 144

Camps/ Manufactured Home Parks Sanitarians also inspect manufactured home parks, campgrounds, and day camps for health and safety. Manufactured Home Parks Licensed 15 Campgrounds licensed 9

Resident Day Camps licensed 6

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Environmental Division Solid Waste Program

In Fairfield County, nuisances like re dumps, garbage piles, or other poten al areas that could harbor rodents or disease-carrying insects are addressed through the Solid Waste Program. This program is funded by landfill user fees through the Solid Waste District, and provides a major benefit for all residents through the clean up of poten al health hazards. In late summer 2012, grant funds became available to townships and municipali es in the State of Ohio. The pur-pose of these funds, labeled “Moving Ohio Forward”, is to provide funding for townships and municipali es to remove unsafe and blighted structures within their jurisdic on. A requirement for obtaining these funds is a declara on from the Board of Health that the structure is unfit for habita-

on. Between September and December 2012, the Board of Health condemned nine structurally unsound buildings to assist townships in this venture. The condemned struc-tures are slated to be demolished in early 2013. Public Health Nuisance Inspec ons 269

Schools/ Correc onal Facili es

Schools and correc onal facili es are inspected to ensure that they meet minimum health and safety standards. School Inspec ons 94 Correc onal Facili es inspected 3

Plumbing Program

The Plumbing Program at the Fairfield Department of Health promotes sound public health prac ces through educa on and oversight of commercial and residen al plumbing systems. Residen al/ Commercial Contractors Registered 57 Residen al/ Commercial Permits Issued 107 Inspec ons 390

Vital Sta s cs The Vital Sta s cs division houses the birth and death cer ficates for Fairfield County. Beginning in December 1908 to present, this comprises over one hundred years of history for the people in Fair-field County. A birth cer ficate is used to prove ci zenship. With-out one, an individual could not obtain a social security number, a driver’s license, enroll in school, or be en tled to any benefits from the U.S. government. This is why the primary func on of the Vital Sta s cs division is to insure Fairfield County has a complete and accurate system of registra on for birth and death records.

The public has the opportunity to obtain cer fied copies of birth and death records from a local Vital Sta s cs office. In 2012, the Fairfield Department of Health Vital Sta s cs office issued 6,994 cer fied copies of birth and/or death records. Without this service offered here at the Fairfield Department of Health, Fairfield County residents would need to travel to another county office or the State office in Columbus.

Contact the Vital Sta s cs office at (740) 652-2836 for assistance in obtaining a vital record. Addi onal informa on is available on the Department’s website; www.myfdh.org

Cindy Sharpe and Jane McGuire

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Public Health Nursing

Cribs for Kids: Grant funds from the Fairfield Founda on enabled the Fair-field Dept. of Health to provide families with Pack and Play cribs. This is an effort to prevent SIDS by providing infants with a safe sleeping environment who otherwise would ei-ther be sleeping with the parents or in an unsafe environ-ment such as a couch or chair. When providing the Pack and Play crib the families are provided informa on about Sudden Infant Death Syndrome and the dangers of unsafe sleeping environments.

Pack and Plays Cribs distributed in 2012: 15

Bureau for Children With Medical Handicaps (BCMH): The part- me BCMH nurse, Pat Garre , RN, BSN, coordinates and manages diagnos c and treatment services for Fairfield County children with suspected or iden fied special health care needs who are on the BCMH program.

BCMH Home Visits: 84

BCMH Coordina on ac vi es: 94

2012 Total number of children on BCMH : 400

Infec ous Disease Inves ga on and Control Program: The Ohio Revised Code requires that all health care providers and laboratories report various infec ous diseases to their local health departments in an effort to protect the communi-ty from disease outbreaks. Health Department staff ensures proper inves ga on, educa on and follow up on all mandat-ed reportable diseases. In 2012, the health department re-ceived 646 reports from healthcare providers, hospitals and labs on mandated reportable infec ous diseases. Of the 646 cases inves gated 465 were confirmed/probable/ suspected cases. The various mandated reportable infec ous disease cases include, but are not limited to, sexually transmi ed diseases, food borne illnesses, vaccine preventable diseases, vector borne illnesses and blood borne illnesses. The staff work closely with county residents, schools, hospitals, physi-cians, community businesses and agencies to prevent the spread of these diseases by providing preven ve educa on, monitoring the spread of the diseases and assuring treatment is obtained and completed.

Front row: Pat Garre , Merrillee Taylor.

Back row: Diana Stover, Jenny Grove, Sheri Johnson, Gwen Shafer.

Help Me Grow: The Fairfield County Help Me Grow (HMG) program contracts with the Health Department to provide developmental evalu-a on services to children within Fairfield County. The Public Health Nurse, Pat Garre , RN, BSN, works closely with HMG to assure that families receive the evalua on services accord-ing to the state mandates.

Developmental Evalua ons completed in 2012: 252

Child Fatality Review Board: The purpose for the Child Fatality Review (CFR) Board is to reduce the incidence of preventable child deaths. The Ohio Revised Code 307.621 mandates coun es in Ohio to par ci-pate in a CFR and to review all deaths of children under 18 years of age from all causes. The CFR Board is required by law to include the County Coroner, Chief of Police or Sheriff, Exec-u ve Director of Children Services, Public Health Official, Ex-ecu ve Director of the ADAMH Board, and a physician. The Fairfield County CFR Board had 11 members a end the annu-al mee ng in 2012. The CFR Board reviewed the 2010 deaths (12) in Fairfield County as per the mandate. The top three causes of deaths for Fairfield County were congenital anoma-lies, prematurity, and other chronic medical condi ons.

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Public Health Nursing

Tuberculosis (TB) Case Management: The Health Department is the appointed TB Unit for the county. As the TB Unit, public health nurses provide TB screenings for county residents who need screened for work, school or as contacts. In 2012, 356 were given. Also in 2012, the Health Department had 5 reported cases of TB, 1 ac ve, 3 suspect cases and 1 latent TB cases. The nurses inves gated and provided case management for 4 of the reported cases, which included home visits, pa ent educa on, contact tes ng, direct observa onal therapy and assurance of proper medical treatment and follow up. In 2012, referrals were received from the US Department of Immigra ons on foreign individuals who are at risk of bringing TB into our community. To protect the communi-ty, Dr. Aebi provided medical examina ons and tes ng on these individuals.

Child and Family Health Service (CFHS): Using CFHS funds provided by the Ohio Department of Health, the nursing division was able to contract with Fair-field County Family and Children First Council to imple-ment a community health assessment. This assessment iden fied a need to improve early prenatal care with Fair-field County women. A focus group lead by the con-trac ng agency has created and developed an educa onal brochure on prenatal care and local resources available to women who have become pregnant. The goal of the focus group is to support women in obtaining and beginning prenatal care within the first trimester of their pregnancy.

Children’s Immuniza on Clinics: Available to all Fairfield County children from birth through age 18, the goal of this clinic is to protect children from preventable childhood illness. The clinic obtains the majority of the vaccines for children from the Ohio Depart-ment of Health at a reduced cost. This enables the clinic to offer vaccines to all children, regardless of their family’s ability to pay. In 2012, 3,206 immuniza ons were provid-ed.

Adult Immuniza on Clinic: Adults who are at high risk for contrac ng a communicable disease through their workplace can receive immuniza ons at the Health Department. This not only protects high risk work-ers from disease but also helps prevent the spread of disease within the community. In 2012, the Health Department pro-vided 373 adult immuniza ons. Fees are for service and can be arranged by a business or individual.

Flu Clinics: Each year the Health Department provides seasonal flu im-muniza ons at various sites and for shut-ins throughout the county, helping to ensure that those who might have difficulty obtaining a flu shot can receive one. Seasonal flu immuniza-

ons were also offered to all Fairfield County employees and the public at various loca ons and worksites. In 2012, the Health Department provided 566 seasonal flu shots at 20 off-site flu clinics throughout Fairfield County.

Travel Immuniza ons: Each year more and more Fairfield County residents travel outside the United States. By providing immuniza ons to trav-elers, your health department helps our residents from be-coming ill while traveling, as well as preven ng poten al dis-ease outbreaks that may come into the county from travelers. The Fairfield Department of Health is a U.S. cer fied Yellow Fever vaccine provider and the nursing staff have been CDC trained in providing the vaccine as well as providing educa on to travelers. In 2012, the travel clinic provided 705 travel im-muniza ons, which included yellow fever, typhoid, polio, and Hepa s A and B vaccines.

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Public Health Nursing WIC Women, Infants and Children (WIC) is a Special Supplemental Nutri on Program that is a federally funded program. WIC helps income eligible pregnant and breas eeding women, and wom-en who recently had a baby, infants and children up to age five who are at nutri onal health risks with a combina on of nutri-

ous supplemental foods such as cereal, eggs, milk, whole grain foods, peanut bu er, beans, fruits and vegetables. WIC pro-vides nutri on educa on, breas eeding promo on and support as well as referrals for obtaining specialty health care. In 2012, the Fairfield County WIC program served 2070 unduplicated par cipants with a total 24, 850 visits per year. In Fiscal year 2012, local WIC projects encountered a mid-year funding cut, which resulted in an $11,059 decrease in funding from $442,362 to $431,303.

WIC par cipants are given the opportunity to work with breas eeding peer helpers. The peer helper program was es-tablished in 2003. The peer helpers are women that received WIC services and breas ed their child or children for at least 6 months. The peer helpers offer support and educa on to preg-nant and breas eeding women.

In 2012 the peer helpers provided breas eeding and infant feeding educa on to over 500 par cipants. Our peer helpers made over 1,500 phone calls to pregnant and breas eeding women in the community offering support and educa on. The peer helpers maintain a breast pump loan program. This loans electric breast pumps to eligible mothers so they can con nue to breas eed their babies a er returning to work or school. In 2012 the peers loaned 55 electric breast pumps.

In the community, the breas eeding peers partnered with Fairfield Medical Center and the Fairfield Department of Health WIC Program to host a “Healthy Baby Fair”. The event was held at Fairfield Medical Center and was open to the general public. Dr. Mar n Harris, a local pediatrician, spoke to a endees about the benefits of breas eeding. Numerous vendors and social service agencies were present to handout informa on and give away door prizes.

Our breas eeding rates in Fairfield County have increased since the peer helper program started in 2003. On average, 50% of the pregnant women on WIC decide to breas eed, that’s an increase from 38% in 2003. Of the women that choose to breas eed almost half of them con nue to breas eed for 6 months or longer, we a ribute this success to the peer helper program.

Front row: Erin Connolly, Amy Gabriel, Debbie Smith

Back row: Lucinda Robinson, Mary Smith, Kay Higgins

The local WIC program works closely with the immuniza on clinic to assure that all infants and children are up-to-date with their required immuniza ons, and enters immuniza on infor-ma on in to the Ohio Impact statewide immuniza on infor-ma on system.

PHEP

The Public Health Emergency Preparedness (PHEP) ac vi es address public health readiness for responding to public health emergencies or threats. These threats or emergencies could include biological, environmental, bioterrorism, weather, or outbreaks of infec ous disease.

PHEP programming focuses on mee ng objec ves in the fol-lowing areas: Planning, Interoperable Communica ons, Epide-miological Surveillance and Inves ga on, Emergency Public Informa on and Warning and Mass Prophylaxis Clinics. Collab-ora on for planning and response ac vi es occurs at the local, regional, state and federal levels.

During the 2012 year, PHEP program ac vi es included: plan maintenance, staff training and exercise opportuni es, disease surveillance ac vi es and public speaking events for emergency preparedness.

Response ac vi es included severe weather response a er a summer Derecho (June), epidemiological surveillance/inves ga on and public informa on in response to the H1N3v virus (August – September) and surveillance ac vi es in rela on to contaminated product that produced cases of fungal menin-gi s (September).