florence county health department annual report.pdf · cervical cancer and genital warts. hpv is...

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Florence County Health Department

Florence

County Health

Department 2017 Annual Report

Connecting You to a Better Life!

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COLLABORATION · COMMITMENT· COMPASSION


The Florence County Health Department (FCHD) met statutory requirements for a level III health department services. The staff provides services with compassion, commitment and collaboration meeting the strategic goals of our department. Our mission is to connect you to a better life! 2017 highlights

• Became an agent for the state through the Department of Trade and

Consumer Protection (DATCP) and began providing inspections to permitted facilities including lodging, restaurants and retail establishments.

• Received Prevention for Success grant for $25,000 to reduce prescription drug misuse in Florence County including distribution of home lock boxes in collaboration with the ADRC, Sheriff’s Office, HSD and local clinic and pharmacy. Participated in two drug take-back days in April and October.

• Amber Kolberg was hired for the role of Emergency Preparedness

Coordinator/Community Health

Specialist in October 2017. • Coordinated Chronic Disease

Prevention programs such as Walk with Ease and Strong Bodies meeting our third health priority on the CHIP.

• Site visit for National Public Health Accreditation in April 2017. • Complete two Quality Improvement (QI) projects improving services

to increase Tdap rates among adults and in creating sustainable Public Health Funding.

Looking forward to 2018

• Florence County Health Department will be a certified water laboratory through DATCP and enter into the Transient Non-community (TN) grant with the DNR to provide onsite water bacteria testing to permitted facilities and the public.

• Standardization grant to assess environmental inspections based on national standards through the Food and Drug Administration.

Executive Summary

FCHD Community

Health Improvement

Plan (CHIP) developed

to improve the health of

Florence County

residents. Focus areas for

the 2015-2020 plan are:

Priority One: Alcohol

and other Drug Abuse

Priority Two: Mental

health awareness and

suicide prevention

Priority Three: Chronic

Disease Prevention

In 2017, FCHD submitted documentation to become a Level III Health Department through the Wisconsin department of Health Services 140 Review. The department was awarded the Level III designation recognizing the highest level of public health services.

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Our Staff

ANNETTE SEIBOLD

AMBER KOLBERG

NANCY OSTERBERG

Cynthia Nichols

ANN PRICE

Director, Health Officer

Public Health Nurse

Administrative Assistant

Emergency Preparedness Coordinator/

Community Health Specialist

WIC Dietitian

Annette has been with the health department for 7

years and provides leadership and oversight for all

programs.

Ann is an RN/RS and has been with FCHD for 4

years. She provides services in the Women, Infants

and Children (WIC) program, communicable

disease follow-up, immunizations, lead screening,

fluoride supplements and facility inspections. She

is also the Accreditation Coordinator.

Our Administrative Assistant joined our team in

November 2016. Cinde is the receptionist, WIC

clerk and provides support and financial

management for all programs.

Amber joined the health department in October of

2017. She is the lead in public health emergency

preparedness and AODA prevention. She has a BS

in nutrition and provides facility inspection

support.

Nancy has worked with the Florence WIC program

for 9 years. She provides respectful and motivating

nutrition counseling and guidance for our WIC

clients.

OUR CORE VALUES

• Commitment

• Compassion

• Collaboration

OUR MISSION

Connecting You to a

Better Life!

OUR VISION

Florence County Health

Department will be a

proactive,

knowledgeable and

professional resource

leading the way to a

healthy, safe and

vibrant community.

BOARD OF HEALTH

MEMBERS

• Holly Wahlstrom-

Stratton– chair

• Susan Theer-vice

chair

• Sherry Johnson

• Yvonne

VanPembrook

• Cindy Kmecheck

• Carolyn Lemanski

• Jason Neuens/Mark

Wenzel

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Maternal Child Health • Public Health Nurse coordinates the Child Death Review Team which meets

biannually to discuss safety and prevention in the community. We will continue to address issues of safety and prevention for youth in Florence County.

• Annual bike safety class to the Florence Elementary 3rd graders with the Sheriff’s Office.

• Question, Persuade, Refer (QPR) coordinated with Florence School District School Psychologist for middle/high school students.

• Facilitated evidence–based abstinence program, “Choosing the Best”, to 7th grade students.

Chronic Disease Prevention • Provided 19 blood pressure screenings and consultation by a RN in 2017. • Facilitated evidence-based, chronic disease prevention programs including

“Walk with Ease”, “Strong Bodies”, and “Eat Smart, Live Strong” in collaboration with ADRC and UW Extension.

Community Human Health Hazards • Investigated one Human Health Hazard in Florence County as required by

State Statute. • Investigations may include collaborative effort with Zoning, ADRC, and

Human Services Department.

Lead • Public Health Nurses documented 43 blood lead tests for children in 2017.

FCHD provides onsite testing for early detection of childhood blood lead poisoning.

Radon • Provided 38 radon kits for residents to test radon levels in their homes and

follow-up consultation for results above recommended level per EPA.

Rabies • Annual Rabies publication to local newspapers. • Conducted investigations of four animal bite reports in coordination with

Florence County Sheriff’s Office as required per State Statue.

School Health • FCHD provides contracted services as a school nurse consultant to the

Florence County Schools. • Completed school immunization review to assure compliance with state

immunization laws. Florence Elementary and High/Jr High School had 99% compliance rates.

Programs ESSENTIAL PUBLIC

HEALTH SERVICES

•Monitor health status.

•Diagnose and

investigate health

problems.

•Inform, educate, and

empower people

about health issues.

•Mobilize community

partnerships.

•Develop policies and

plans.

•Enforce laws and

regulations.

•Link people to

personal health

services.

•Assure competent

workforce.

•Evaluate population-

based health services.

•Research new

solutions to health

problems.

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Environmental Health Inspections

Month Lodg-ing

Retail Campgrounds Restau-rants

Temporary/Mobile Restau-

rants

Pools Total

July 3 0 0 1 0 0 4

Aug 4 2 1 2 2 1 12

Sept 2 0 0 0 0 0 2

Oct 0 2 0 2 0 0 4

Nov 1 1 0 1 3 0 6

Dec 0 0 0 1 0 0 0

2017 Totals

10 5 1 7 5 1 28

*Florence County Health Department as an agent of the state of Wisconsin under Wis Stat 97.30 and Subchs.III and IV of ch 97, and Wisconsin Administrative Code ch ATCP 74 issues licenses to, inspect, and regulate retail food establishments including restaurants, campgrounds, recreation-al and educational camps, public swimming pools and water attractions, hotels, motels, tourist rooming houses and bed and breakfast establishments enforcing all applicable provisions of the Wisconsin statutes and Administrative Code and associated State Department policies.

As of July 1, 2017

Florence County

Health Department

began inspecting

facilities regulated

by the Department

of Trade and Con-

sumer Protection in

accordance with

state statues and

the Federal Retail

Program Standards.

The chart provides

an updated report

on facilities inspect-

ed in Florence

County.

Water Quality

• Assisted 38 private well owners to test their well water coordinating with the

Wisconsin State Lab of Hygiene for testing including Bacteria, Nitrates, Fluoride,

and metals.

• Municipal water systems provide safe drinking water to the Town of Florence

and parts of Commonwealth and test their water regularly to ensure it is safe,

but it is up to private well owner to test their well water annually.

• Florence County Health Department initiated a water lab for bacterial testing of

private wells.

• Through a contract with the Wisconsin Department of Natural Resources, 39

transient non-community water supply systems will be tested to ensure that

safe and dependable water is available to the public. Wells of businesses that

serve the public are also inspected for structural soundness and routes of po-

tential contamination.

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WIC is a Federal supplemental nutrition program that focuses on breastfeeding support and healthy eating for pregnant women and families with children under 5. 2017 highlights • eWIC debit card system for WIC clients

continues to provide a more pleasant and efficient shopping experience for our WIC families.

• The amount of benefits redeemed in the year 2017 at local vendors was $32,450.81.

• FCHD averaged 73 families with a total of 108 WIC participants overall.

• WIC Director provided training and required reviews for Farmers Market and WIC grocery vendors.

• Farmers markets are coordinated locally in a continued effort to provide increased access to fresh vegetables.

• In 2017, 45% of the WIC families participated in the Farmer’s Market Nutrition Program and spent a total of $216.00 at local Farmer’s Markets.

Women, Infants & Children (WIC)

WIC BePC Principles

“Being Person-Centered”

communication skills

• Respect

• Individualize

• Motivate

• Empathize

• Listen to Understand WIC Moms Who Have Initiated Breastfeeding

WIC participants

that have ever initi-

ated breastfeeding

their infants has re-

mained above the

State of Wisconsin’s

rate since 2013.

66.8%68.3%

70.5%

71.5% 72.1% 72.6%

72.5%72.3% 72.8%

51.5%

61.1%

78.3%

66.7%

71.4%

92.3%

87.5% 83.0%

73.0%

2009 2010 2011 2012 2013 2014 2015 2016 2017

State Florence County

*It is noted that data may have limited interpretive value due to the small numbers.

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Certain diseases must be reported to local health departments by law. FCHD staff regularly receive and investigate these communicable diseases through WEDSS (Wisconsin Electronic Disease Surveillance System).

Disease Prevention and Control

2017 Top Communicable Diseases investigated in Florence

Lyme Disease most commonly reported in 2017

Wis. Stats. 252.05:

Any health care provider

who knows or has reason

to believe a person

treated or visited by him

or her has a

communicable disease is

required to report. Per

Administrative Rule DHS

145.04 (1), this includes

reporting of a case or

suspected case.

0

5

10

15

20

25

30

35

40

45

2016

2017

Reporting and follow up

guidelines for Lyme dis-

ease changed and alt-

hough many positive

blood tests for Lyme dis-

ease were reported,

only cases with a report-

ed erythema migrans

(bull’s eye rash) were

counted as a case.

* It is noted that annual data may have limited interpretive data due to the

small numbers.

Top Communicable Diseases

Florence County

1. Lyme Disease

2. Chlamydia

3. Hepatitis C

4. Campylobacter

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Many serious diseases can be prevented by vaccines. The Florence County Health Department provides a wide range of childhood and adult immunizations at regularly scheduled immunization clinics and community satellite clinics to reduce barriers to care. 2017 highlights

• Received HPV grant to increase awareness and education through movie “Someone You Love.”

• Utilized Wisconsin department of Health Services immunization grant for Mass Clinics to offer free adolescent vaccine at school based clinics including Tdap, Meningitis and Flu (and Medicaid eligible for HPV).

• Implemented Quality Improvement projects to improve Adult Tdap coverage and public health funding.

• Added a satellite clinic in the town of Tipler. • Florence County Health Department is a member of the Northwoods

Immunization Coalition, which includes public/private providers from Vilas, Oneida and Forest Counties.

• Due to implementing school based immunization clinics, FCHD has been able to continue to increase immunization rates by increasing access to care for underinsured and uninsured adolescents.

Immunizations

Tdap

Meningitis

HPV

Series

2017 Adolescent Immunization Rates

Florence County rates continue to trend upward

Definitions

Tdap (Tetanus,

Diphtheria, and Acellular

Pertussis) – protects

against Pertussis

(whooping cough)

Tetanus and Diphtheria.

Pertussis is highly

contagious.

• HPV (Human

papillomavirus) -

protects against the

types of HPV that most

commonly cause

cervical cancer and

genital warts. HPV is

most common in people

in their teens and early

20s.

• Meningococcal

(Meningitis) - protects

against Meningococcal

Meningitis, a very serious

infection of the lining

around the brain and

spinal cord that can

cause death.

FCHD remains on an upward trend for adolescent immunization rates surpassing state rates

in 2016-17. 2016 Wisconsin state rates for: Tdap –78%; Meningitis-38%; and HPV Series-

29% (Wisconsin Immunization Program, March 2017).

2017 TB (tuberculosis)

tests

administered

19

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Immunizations

2016-17 Vaccines for Children (VFC) Doses Administered

Fact:

The injectable vaccine does not

contain any live bacteria so it

is impossible to get influenza

from it. There may be some

side effects, such as mild sore-

ness, redness or swelling at the

injection site, headache or a

low-grade fever.

Student receives a vaccine at a school-based clinic providing increased access to healthcare in our community.

Children Up to Date on Immunizations at 24 Months

0 10 20 30 40 50 60 70 80 90

Dtap

Polio

MMR

Varicella

Pneumoccocal

Hib

Tdap

Influenza Quadrivalent 3y - 18y

Influenza Quadrivalent 6m-35m

Meningococcal

HPV Gardisil 9

Hepatitis B

2016 2017

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Northwoods Dental Project



Tobacco Prevention Research shows that multi-component interventions that include merchant and community education, regular inspections, and penalties for vendors who sell to minors have been shown to reduce illegal tobacco sales, which in turn decreases youth smoking.

2017 WI WINS Compliance checks

Florence had a 8% sales rate with 1 sale to minor by a clerk

Northwoods Dental Project, a partnership between Oneida, Vilas, Florence and Forest counties, has been working to prevent tooth decay and create awareness of oral health. According to research, school-based sealant and fluoride varnish programs have been associated with reducing the incidence of tooth decay by 70 percent.

FLUORIDE

SUPPLEMENT

PROGRAM

Florence County

Health Department

provided fluoride

supplements (tablets

or drops) to 17

children in 2017

Healthy Smiles Fluoride Varnish Program Highlights

School Year 2013-14 2014-15 2015-16 2016-17 2017-18

Students participating 32 23 41 39 22

Students referred for un-

treated dental decay 5 6 13 9 3

% of students on Medicaid 55.9% 42.1% 39% 57.1% 45.4%

Seal-a-Smile Dental Sealant Program Highlights

School Year 2013-14 2014-15 2015-16 2016-17 2017-18

Students receiving educa-

tion 50 54 57 56 57

Students receiving oral

health exams & dental sup-

plies

30 26 40 36 35

Students receiving sealants 23 21 26 24 17

Students referred for un-

treated dental decay 11 4 18 8 10

% of students on Medicaid 39% 55% 35% 47.2% 45.7%

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Federal funding for emergency preparedness is provided at all levels of government, and working with community partners to prepare for disaster continues to be a high priority for our agency. 2017 Highlights

Exercises

• Organized Mass Clinic Exercise at Florence High School and Elementary in October

to dispense influenza and adolescent vaccines through a state grant • Participated in Regional Healthcare Emergency Response Coalition (HERC) Ebola

exercise in May and submitted After Action Report to the state with regional partners.

• Participated in Regional HERC Hazard Vulnerability Assessment (HVA).

Preparedness Activities

• CDC annual Review of Strategic National Stockpile

plans through Point of Distribution (POD). • Quarterly Local Emergency Planning Committee

(LEPC) Meetings. • Respirator Fit Testing for FCHD nursing staff. • Reviewed Florence County Mass Clinic Plan. • Reviewed Public Health Emergency Preparedness Plan. • Emergency Preparedness booth at Florence County

Library and Florence County Courthouse to educate awareness. • Facilitated Wisconsin-Michigan Border Coordination Group meetings in April and

September. The group includes 8 health departments, Emergency Management, American Red Cross, Michigan Healthcare Region 8, Wisconsin Healthcare Regions 2 & 3, Wisconsin Northern Region DPH, and Florence County Sherriff’s Office.

• Updated Risk Communications Plan. • Revised 24/7 Contact Call Down to assure public health staff availability and

exercised three different times in 2017.

Trainings

• Radio training with Sherriff’s Office in September. • Received training grant supporting Wisconsin Public Health Association Infectious

Disease and Emergency Preparedness.

2018 Planned Activities

• County-wide Emergency Operations Center (EOC) exercise on February 17th. • Mass Clinic After Action Report. • School-based mass clinics. • Revising Public Health Emergency Preparedness (PHEP) and Mass Clinic Plans.

Emergency Preparedness

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Financial

Revenue Sources for 2017

2017 Total Revenue $332,958

Federal, State, Fee for Service Revenue $168,474

County Levy $164,484

*Florence County Health Department utilized less tax levy than anticipated due to the revenue

from grants and programs in 2017.

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Client Feedback

“Excellent program! Keep it going! - Keeping It Real Adult Participant

“The speakers were an amazing inspiration!- Keeping It Real Student Partici-pant

“It gave me a different point of view on sex, drugs and alcohol. It is very helpful

so you can know how to say NO.” Choosing the Best—Path, 7th Grade Student

“We appreciate the consistency of inspections in our county.” - Establishment

Owner

“I appreciate the communication and information on communicable disease and

when I should take my child in.”- Florence County Parent

“Excellent service! My kids and I were in great hands, very helpful.” - WIC Partic-

ipant

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