report to the board of health – march 2016 · report to the board of health – march 2016 ....

Report to the Board of Health – March 2016 Winnebago County Health Department Leadership Team

• Kyle Auman – Health Equity Coordinator • Sue Fuller – Public Information Officer • Lisa Gonzalez, MPH – Center Director, Family Health Services • Theresa James – Emergency Response Coordinator • Todd Kisner, MPH – Center Director, Health Protection and

Promotion • Todd Marshall, LEHP – Center Director, Environmental Health Improvement • Patrick Madigan – Finance Director • Karalyn Nimmo, MPH – Data and Quality Coordinator

• Domain I – Monitor Health Environmental Health Improvement (EHI) continues to monitor for critical violations for all EH programs to identify areas where more education is needed for food operators, contractors, and landlords. Indoor Air Monitoring # of

Units CO2 Temp Humidity CO

Month Average 3 999 ppm 72.5 40.4 0.5 ppm Month Max 3 1211 ppm 77.6 51.3 0.9 ppm YTD Overall Avg 8 889 ppm 70.9 33.9 0.7 ppm YTD Overall Max 8 2130 ppm 78 51.3 1.5 ppm CO2 CO YTD-CO2 YTD-

CO IDPH Guideline (ppm) > 1,000 > 9.0 > 1,000 > 9.0 Homes with at least one reading exceeding guideline 3 0 5 0

% of Homes Monitored 100.0% 0.0% 62.5% 0.0% Homes whose overall average exceeds guideline 1 0 2 0

% of Homes Monitored 33.3% 0.0% 25.0% 0.0%

Board of Health Report March 2016 - of 22

Radon

The EPA strongly recommends that homeowners install radon mitigation in homes at or above 4.0 pCi/L, and that homeowners should consider mitigation at levels between 2.0 and 4.0 pCi/L. Mosquito Surveillance and Control The 2015 Vector Control grant program officially came to an end in March. The 2016 Vector Control grant begins April 1. During this off-season, the WCHD is continuing work on the County Mosquito Plan. All municipalities in Winnebago County have responded to survey, indicating their surveillance and abatement activities, as well as their training needs. The WCHD will incorporate this information into the County Mosquito Plan. WCHD staff have developed a newsletter that will be sent to leaders of neighborhood organizations throughout the County. The WCHD hopes to use these organizations to assist with distribution of program educational literature, to assist with surveillance by identifying areas of need, and potentially assist with abatement activities. Illinois Youth Survey ATOD (Alcohol Tobacco, and Other Drug) specialist continues to work with the remaining unregistered schools in Winnebago County to advocate for participation in the Illinois Youth Survey (IYS) which is anticipated to be completed by May 2016. Dr. Martell provided assistance in advocating for participation though a letter to the principals of each of the schools who had not registered. The survey provides valuable information from 8th, 10th and 12th graders to their school and the county regarding drug perceptions and usage trends. The data supports effective program planning. Currently only 15 out of 30 schools (50%) are registered to do the survey. WCHD has set a goal of 50% participation and is working with the remaining 15 schools to enlist their participation in the IYS. Sexually Transmitted Infections

STIs Seen Through WCHD Clinical Services

YTD 2016 2015 Year Total

Cases 2014 Year Total

Cases

Syphilis 2 9 5

Gonorrhea 19 75 117

HPV 1 44 111

Chlamydia 37 197 339

HIV 1 2 0

Phone Calls

Number of Units

Radon Screenings

Average (pCi/L)

Max (pCi/L)

Number of Mitigation

March 2016 16 5 5 4.9 11.2 1 FY16 to Date 59 16 16 3.2 11.2 2 Program total 100 39 39 4.3 14.0 10


The Communicable Disease Team consisting of the Disease Intervention Specialists (DIS) continue their efforts in identifying and preventing further spread of Sexually Transmitted Infections (STI) in the County. Whether seen in WCHD Clinical Services or by a community healthcare partner, the DIS Team through partner elicitation and notification, are able to identify contacts (i.e. partners) to an STI and work with them to receive treatment and STI prevention messages. The DIS Team conducts at length an interview with an individual testing positive for syphilis. As this disease is more complex in diagnosis, an interview provides greater details to the behavior(s) of the individual testing positive along with determining the approximate point of exposure to the infection, the stage of the infection, and selection of the most effective evidence-based treatment based on CDC guidelines.

• Domain 2 – Diagnose and Investigate CLSR (Creating Lead Safe Rockford) 2013 Objectives Note

The Notice of Funding Availability for HUD’s 2016 lead grants was posted in March. Applications are due April 28, 2016 and the WCHD is working hard on its submission. The WCHD was not awarded these funds in 2015, in part due to having an active grant at the time. The active grant will expire by the end of 2016, so continuation of the program will be dependent on this year’s award. The WCHD is strengthening its application this year by incorporating all of the comments and suggestions given by HUD in the debriefing of the denied 2015 application. The WCHD is working on getting letters of support from local elected leaders as well as MOUs from partner organizations such as Boone County Health Department, Crusader Community Health, and the local housing authorities.

Food Complaints

Month FY 2016 FY 2015 # of Foodborne Illness Complaints 3 17 10 # of Foodborne Illness Investigations 3 17 10 # of Non-foodborne Illness Complaints 17 80 74

Goal Actual Percent Units Enrolled 300 169 56.3 % Inspections 250 147 58.8 % Mitigated Units 225 114 50.6%


Housing Complaints

The Neighborhood Code Enforcement program is currently working to bring garbage disposal service

to more areas in unincorporated Rockford’s west side. Through complaint statistics, the WCHD has identified a specific area where this service is much needed. Program staff have contacted the three (3) major waste disposal companies in Winnebago County, who are each reviewing the area. The WCHD will facilitate meetings between these waste disposal companies and the residents of the area. The WCHD hopes to have a meeting at a community center in that area to make it most convenient for its residents. Our goal is to empower the residents to establish their own relationship with the waste disposal companies, without any financial or legal obligations from the County.

Well and Septic Complaints

Original complaints

Recheck complaints

FY16 Original complaints

FY16 Recheck complaints

FY15 Original complaints

FY15 Recheck complaints

Wells 1 2 10 13 6 12 Septic 6 5 17 10 4 23

Communicable Diseases

Vaccine Preventable Diseases (Reporting timeframe)

March 2016

Confirmed Cases

2016 YTD Investigated

& Determined

"Not a Case"

2016 YTD Total

Confirmed Cases

2015 Year Total

Confirmed Cases

2014 Year Total

Confirmed Cases

Chickenpox (Varicella) (24h) 0 0 0 2 3 Diphtheria (immediate) 0 0 0 0 0 Haemophilus influenzae, invasive (24h) 1 0 1 5 7 Hepatitis A (24h) 0 2 0 0 1 Hepatitis B-Acute Infection (7d) 1 0 1 1 2 Hepatitis B-Chronic (7d) 2 0 4 2 28 Hepatitis C-Acute (7d) 0 1 0 1 0 Hepatitis C-Chronic (7d) 23 10 47 239 235 Hepatitis D (7d) 0 0 0 1 1 Influenza deaths in < 18 yrs old (7d) 0 0 0 0 0 Influenza A, variant (immediate) 0 0 0 0 0 Influenza, ICU admissions (24h) 1 5 3 6 15 Measles (rubeola) (24h) 0 0 0 0 0 Mumps (24h) 0 0 0 0 0

Month FY 2016 FY 2015 # of Housing Complaints 65 330 306 # of Nuisance Complaints 32 77 75 # of Survey Complaints 37 246 258 # of Received Complaints 106 629 697 # of Re-check on Complaints 369 2025 2098


Neisseria meningitidis, invasive (24h) 0 0 0 0 0 Pertussis (whooping cough) (24h) 0 1 0 9 16 Polomyelitis (immediate) 0 0 0 0 0 Rubella (24h) 0 1 0 0 0 Streptococcus pneumoniae, invasive disease, in those < 5 yrs old (7d) 0 0 0 3 2 Tetanus (7d) 0 0 0 0 0

Sexually Transmitted Infections AIDS (7d) 0 0 0 11 11 Chancroid (7d) 0 0 0 0 0 Chlamydia (7d) 167 5 423 1751 1702 Gonorrhea (7d) 75 1 168 544 443 HIV infection (7d) 1 0 1 18 18 Syphilis (7d) 3 0 5 22 8

Other Communicable Diseases Anaplasmosis (7d) 0 0 0 0 0 Any suspected bioterrorist threat (immediate) 0 0 0 0 0 Any unusual case or cluster of cases that may indicate a public health hazard (immediate) 0 0 0 0 0 Anthrax (immediate) 0 0 0 0 0 Arboviruses (including WNV) (7d) 0 0 0 0 0 Babesiosis (7d) 0 0 0 0 0 Botulism, foodborne (immediate) 0 0 0 0 1 Botulism, infant, wound, other (24h) 0 0 0 0 0 Brucellosis (24h unless bioterrorism suspected, then immediate) 0 0 0 0 0 Campylobacteriosis (Became Reportable in 2016) 0 5 1 n/a n/a Chikungunya Non-neuroinvasive Disease 0 0 0 0 0 Cholera (24h) 0 0 0 0 0 Creutzfeldt-Jakob Disease (7d) 0 0 0 0 0 Cryptosporidiosis (7d) 0 0 0 5 4 Cyclosporiasis (7d) 0 0 0 0 0 Drug-resistant organism, extensively (7d) 0 0 0 0 0 Ehrlichiosis (7d) 0 0 0 0 0 Enteric E. coli infections (STEC,O157:H7, ETEC, EPEC, EIEC) (24h) 0 1 0 7 5 Foodborne or waterborne outbreaks (24h) 0 0 0 0 0 Hantavirus pulmonary syndrome (24h) 0 0 0 0 0 Hemolytic uremic syndrome, post diarrheal (24h) 0 0 0 0 0 Histoplasmosis (7day) 0 0 0 0 0 Legionellosis (7d) 2 0 2 8 3 Leprosy (7d) 0 0 0 0 0 Leptospirosis (7d) 0 0 0 0 0


Listeriosis (7d) 0 0 0 0 0 Lyme disease (7d) 0 3 0 7 8 Malaria (7d) 0 0 0 1 0 Ophthalmia neonatorum (gonococcal) (7d) 0 0 0 0 0 Outbreaks of public health significance (24h) 0 0 0 0 0 Plague (immediate) 0 0 0 0 0 Psittacosis (7d) 0 0 0 0 0 Q fever (2 4h unless bioterrorism suspected then immediate) 0 0 0 0 0 Rabies, human and potential human exposure and animal (24h) 1 0 0 16 1 Reye syndrome (7d) 0 0 0 0 0 Salmonellosis, other than typhoid (7d) 4 0 8 57 40 Severe Acute Respiratory Syndrome (SARS) (immediate) 0 0 0 0 0 Shigellosis (7d) 10 0 40 116 21 Smallpox (immediate) 0 0 0 0 0 Smallpox vaccination, complications of (24h) 0 0 0 0 0 Spotted fever rickettsioses (7d) 0 0 0 0 0 S. aureus, Methicillin resistant (MRSA) clusters (two or more lab confirmed cases) in a community setting (24h) 0 0 0 0 0 S. aureus, Methicillin resistant (MRSA) in infants <61 days (24h) 0 3 3 9 11 S. aureus infections with intermediate or high level resistance to vancomycin (24h) 0 0 0 0 0 Streptococcal infections, Group A, invasive including STSS and necrotizing fascitis (24h) 2 0 4 11 6 Toxic shock syndrome due to S. aureus (7d) 0 0 0 0 0 Trichinosis (7d) 0 0 0 0 0 Tuberculosis (7d) 0 0 0 0 6 Tularemia (24h unless bioterrorism suspected then immediate) 0 0 0 0 0 Typhoid fever (24h) 0 0 0 0 0 Typhus (24h) 0 0 0 0 0 Vibriosis (non cholera) (7d) 0 0 0 2 1 Yersiniosis (7d) 0 0 0 0 0 West Nile Fever 0 0 0 0 0 Zika Virus 0 4 0 n/a n/a

* The above table represents only those reportable diseases that have been received this month and year to date in comparison to the previous two year totals. * ”Investigated & Determined Not a Case” Column indicates an investigation was completed on a “probable” case of the disease noted. As the final diagnosis was not the specified disease, then the investigation work falls in this reporting category.


Communicable Disease Activities 1. Shigella Outbreak:

On March 22, 2016, WCHD hosted the Community Task Force on Shigella in response to the community outbreak of the disease. Seventeen (17) individuals attended the meeting representing daycares, elementary schools, hospitals, academia and the Health Department. A presentation was made as to the current outbreak by Kimberly Weems, Graduate Research Assistant. Dr. Mark Dworkin also provided insight on outbreak control and his experience with a community Shigella outbreak in Stephenson County. The participants discussed additional means to control the spread of Shigella. Hand washing can end the outbreak. Reemphasis on hand washing before meals and after toileting are key strategies to end the outbreak. The spread of Shigella through the community can visualized in the following epi curve:


2. Zika Virus Disease: The Communicable Disease Team is working with the Illinois Department of Public Health (IDPH) and our local health care providers (especially OB/GYN providers) to provide the opportunity for Zika testing to an individual who meets the CDC eligibility criteria for testing. A request for Zika virus testing should be initiated by health care provider when testing criteria is met in collaboration with the Health Department. WCHD has authorized a total of twelve (12) requests for Zika Virus testing. As of March 31, WCHD has received eight (8) negative testing results. The remaining four (4) tests are pending for results of the testing.

The CDC released new updated interim guidance for Zika Virus Disease on the following subjects http://www.cdc.gov/zika/pregnancy/index.html :

1. Pregnant and reproductive age women and male partners 2. Preventing sexual transmission of Zika

Zika virus can be spread from a pregnant woman to her fetus and has been linked to a serious birth defect of the brain called microcephaly in babies of mothers who had Zika virus while pregnant. CDC recommends special precautions for pregnant women. The Leadership Team at WCHD continues working on the County’s responses to Zika through surveillance, public information on social media and mosquito abatement. The Team meets weekly to discuss latest developments and changes in WCHD response.

3. Seasonal Influenza WCHD is continuing its seasonal influenza surveillance in conjunction with our community partners. The flu on the decline over the past several weeks in the community. To provide influenza surveillance data to our community, The CD Team publishes its weekly influenza report. The following graph displays the current flu activity in our County.

http://www.cdc.gov/zika/pregnancy/index.html


Domain 3 – Inform, Educate, and Empower Social Norms Marketing (SNM) Campaign Three (3) high schools have agreed, Jefferson HS, Auburn HS, and Harlem HS, to host at each school a Tobacco Social Norms Project within their school to change the perception and use of Tobacco at the individual sites for high school students.

Schools # Students involved

# sessions provided

# hours provided

(includes 1 hour prep)

Progress

Auburn HS 12 3 6 Working with contact to meet with students

2x in April to complete project

Jefferson 14 3 6 Program wrapping up due limited time spent with students and timeframe to complete project

Harlem 33 4 15

Two classes of 16 students (marketing and design) who have met and developed messages; will meet with school contacts to complete and distribute messages in May for next school year

Substance Abuse Youth Prevention Education The ATOD Specialist has been providing The All Stars Youth Prevention Education in March to a total of 46 students. The prevention message(s) are delivered in five (5) groups of students a week in the three (3) middle schools (Lincoln, West and Flinn). It is anticipated that the education groups will end in May as school is ending for the summer. A summer education program is in the planning stages. Electronic and Social Media Contacts for Mar 2016

WCHD Website Page 10,615 Page Views 3,562 Sessions 2,752 Users Facebook 1,336 Avg. Weekly Reach 85 Avg. Weekly Engagements 580 Total “Likes” Twitter 55.7 K Tweet Impressions 2 New “Likes” 677 Followers

Intranet Page 2,909 Page Views 716 Sessions 453 Users

mailto:[email protected]

http://twitter.com/WinnCoHealth

http://www.facebook.com/pages/Winnebago-County-Health-Department-Rockford-IL/222539346139

http://www.youtube.com/user/WinCoHealthDept?feature=mhee

http://www.wchd.org/


State Budget Impasse Eroding Local Public Health Departments in Northern Illinois On March 10, the Rockford Region Public Health PIO work group sent out a coordinated news release to media partners on behalf of the Public Health Administrators in Illinois Region 1 representing Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside, and Winnebago Counties. The release defined how collectively each Health Department in this region have had to take significant measures to make certain that public health activities remain stable during this current budget impasse. The media release generated several television, radio, and print interviews, plus as an op-ed piece in many newspapers across the region.

YWCA Leadership Luncheon On Monday, March 7, 2016 Dr. Sandra Martell invited BOH members, leadership staff, and Melissa Westphal from Rosecrance representing the Mental Health Advisory Committee to attend the annual Northwestern Illinois YWCA Leader Luncheon and Women of Achievement Awards. This was a special occasion for the YWCA as they were celebrating 125 years of empowering women. Along with honoring many women in our area for their contributions in the work place, and community volunteerism, the guest speaker Lily Ledbetter, inspired the audience with her presentation on pay equality for women.


Zika In February, a Zika page was uploaded on the Winnebago County Health Department website. This page includes general information on the virus, physician information, travel recommendations where Zika is circulating, along with an imbedded CDC microsite on the subject. The microsite is directly linked to the CDC website. As CDC’s Zika page is updated with new information, so is the WCHD Zika webpage. WCHD continues to post new and pertinent information on social media regarding this health topic.

Lung Cancer Screening Health Promotion Supervisor is working with University of Illinois College of Medicine at Rockford to offer a Lung Cancer CT scan seminar for residents of Rockford and Winnebago County Housing Authorities to create awareness about the CT tool available with assistance from insurance for long term, heavy usage smokers. The community presentation will take place in April. WCHD clients will also be invited to attend.

• Domain 4 – Mobilize Community Partnerships Winnebago County Tornado Drill Exercise Several PIO’s from the area participated in the Winnebago County Tornado Drill large scale exercise on Friday, February 19, 2016. As part of this exercise, the Winnebago County and City of Rockford both set-up Joint Information Center’s (JIC). The PIO’s in both locations tested the new Winnebago County All Hazards PIO Plan. This was the first time that several area PIO’s worked together in a JIC setting. The PIO’s worked well together, and suggested more risk communication exercises would be beneficial to increase our capabilities in responding to a large-scale emergency. Substance Abuse Prevention Coalition The goal of the Coalition is to increase the number of representatives along with increase awareness activities in Winnebago County. The following chart represents the meeting activities of the coalition.

Month Date of Coalition

Meeting # hours provided

by ATOD # members attending

August 08/18/2015 1 8 September 09/15/2015 1 7 October 10/20/2015 1.5 7 February 02/16/2016 1.5 11 February 02/25/2016 1 7 March 03/14/2016 2 4 March 03/22/2016 1.5 11


Transform Rockford Dr. Martell continued to represent the Winnebago County Health Department on the Transform Rockford (TR) Healthy Lifestyles Spoke workgroup. The workgroups are waiting for direction from the steering committee on organization and representation on the “Tactics” teams. A meeting of the Renewal Teams – Education, Leadership and Youth, and Healthy Lifestyles is being convened to discuss early intervention from the pre-conceptual period through the first 3 years of life. Business First

WCHD continues to participate in the BusinessFirst Initiative. On March 11th , each participating agency submitted additional questions to the existing survey to ensure that clients prior to starting the process have a viable, developed business plan to improve efficiency and efficacy of

the review process and time commitments of the participating agencies.

• Domain 5 – Policies and Plans IPLAN Community Assessment In honor of Public Health Month (April) we will be completing the Public Health System Assessment, which evaluates local public health resources as aligned with the Core Function and 10 Essential Services of public health. National Public Health Standards will be used to guide the process. The Steering Committee has assisted in identifying partner organizations to complete the assessment. The interactive presentation prepared will collect data using the Keypoint® audience response system. The committee has practiced this presentation at the March All-Staff and will use an After Action Report to work out bugs in the presentation software. The IPLAN Steering Committee has agreed upon a format for the Themes and Strengths portion of the assessment. This portion will be completed thought a Survey Monkey and paper survey, delivered to community members at various contact points in the community. The committee is beginning to identify these contact points and will enlist community partner support to reach a desired 2,000 responses. A vision session was completed by the Leadership Team to identify what health meant to them. This has helped to set the tone for the assessments moving forward.


The IPLAN Steering Committee is beginning preparations for the Board of Health to complete the Forces of Change Assessment. This assessment will be introduced at the May Board of Health Meeting. An “Active Shooter Exercise”was conducted on March 11th at 555 North Court to test the response plan of the Winnebago County Health Department and its tenants including the City of Rockford Department of Human Services, Veterans, Parkside Dental. Law enforcement and first responder support was provided by Rock Valley College Police; Rockford Police Department; Rockford Fire; Rockford Chaplains; Winnebago County Sheriff; and Winnebago County Office of Emergency Management. The drill concluded a month-long series of individualized trainings and physical plant walk-through to determine escape routes and secure hiding areas in the event of an active shooter on the campus. An After Action Report has been developed based on the observations and input from all participants with the goal of revising plans and improving response.

• Domain 6 – Enforce Laws

EHI Code Enforcement Stats

Monthly Inspection

FY 2016 Inspections

FY 2015 Inspections

Foods 319 1859 1790 Wells 8 58 27 Septic 4 39 43 Loan Inspection 47 226 250

Administrative

Hearing Month

In-House Hearing Month

Administrative Hearing (FY16)

In-House Hearing (FY16)

FY 2015 Administrative Hearings

FY 2015 In-House Hearing

Housing 3 14 42 138 62 134 Foods 0 2 0 14 0 10 Well/Septic 0 0 2 12 2 7

Report of Food Facility In-house hearings

1. Da Catch Fish & Chicken 2904 West State Street; Rockford, IL Date: 3.8.2016 Violations: temperature control, waste water, hand sink accessibility

2. Da Catch Fish & Chicken 1528 Kishwaukee Street; Rockford, IL Date: 3.15.2016 Violations: temperature control, certified operator, hand washing, chemical labeling

Pools No further information has been provided by the Rockford Park District in relation to the inspection and recommendations provided by their outside consultation regarding the safe operation of the Splash Blaster water coaster.


CoCo Keys continues to remain closed. There has been no communication that the facility has addressed any of the reported health and safety violations. Continued spot checks have been performed to ensure compliance with the closure order. Illinois Tobacco Free Communities Grant/Smoke-Free Illinois Act

Tobacco Compliance Checks Conducted for 2016:

Month Random

Compliance Checks

Targeted Enforcement Complaints

Targeted Out of

Compliance

Citations issued

Pre Hearing

Calls

In person Administrative

Hearings

Number of Environmental

Health Referrals (Lack

of Signage) January 0 7 6 (86%) 1 0 0 9

February 0 3 1 (33%) 0 0 0 6 March 0 1 0 0 0 0 3

Illinois Liquor Control Commission Grant: Tobacco Enforcement Program Working with the Sheriff’s Department, Tobacco Compliance Checks were completed on March 4, 2016. A Sherriff’s deputy accompanies the youth to the local tobacco retailer to check compliance with State law. There are 178 tobacco retailers in Winnebago County that are subject to be checked on through this program.

TEP Check Dates

# students involved

# checks completed

ATOD Specialist Hours provided

Dec. 1 10 170 10 (includes training time) March 4 8 135 6 May

• Domain 7 – Link to/Provide Care iGrow

iGrow – Coordinated Intake for Home Visiting

March 2016 FY16

February 2015 FY16

January 2015 FY16

Total YTD FY16

Total FY15

# CIAT Completed (Coordinated Intake Assessment Tool)

117 75 111 551 660

# Referred to Partner Home Visiting Programs

22 6 33 117 443


Audio/Visual Program Hearing and Vision screenings took place at a number of private preschool and K-8 programs. Priority for services remains for Preschool age children with a number of preschools scheduled for screenings for March and April.

Month Total Monthly Hearing Screenings in 2016

YTD Hearing Total 2016

Preschool Participants 2016

Preschool YTD Screenings 2016

February 427 1412 312 715 March 256 1668 224 894

IPC – Affordable Care Act

Dr. Martell and Lisa Gonzalez continue to work with the Winnebago County Probations Department to build sustainability for healthcare coverage enrollment for the probations and pre-trial populations. Health Department assists by

completing a query of the MEDI system in order to identify those probation/pre-trial clients that have active Medicaid or Medicare coverage. The Probation Department utilizes the information to better refer probation clients for enrollment assistance. On average, the Health Department processes 3 separate lists per day for the two different populations, or approximately 75 individual queries per day. Initial results have shown that on average approximately 50% of individuals queried are covered under Medicaid or Medicare. A lease agreement has been provided to the Patient Innovations Center (PIC) for the former In-person Counselor (IPC) space in the 555 North Court building to promote continuity of services for ACA enrollment. Women’s Health Services The Family Planning Program had an Illinois Department of Human Services Title X site review on January 8, 2016. The general findings from the review resulted in a program need to increase the number of adolescents and males served in the program, increase the number of clients screened for Chlamydia and a need to focus on comprehensive adolescent reproductive health counseling. The Corrective Action Summary will be submitted to the Board of Health Quality Committee in April 2016.

Family Planning March 2016

2016 YTD

March 2015

March 2014

Number of Clients Seen 159 444 343 413 New Clients 29 77 73 105 Continuing Clients 130 367 270 413 Pregnancy Tests 71 207 105 223


Illinois Breast and Cervical Cancer Program (IBCCP)

Integrated Clinic Services by Visit Type

6%

8%

32%

16%

% IBCCP YTD Enrollment By Age n=417

Under 35

35-39

40-49

over 50

75%

80%

85%

90%

95%

100%

Breast CancerScreening Cervical Cancer

Screening

84%91%

12% 0%

4%

1%

Abnormal Screening Follow up Completed YTD Target = 60 Days

>90…

WCHD Clinic Visit Type by Month Visit Type 15-Sep 15-Oct 15-Nov 15-Dec 16-Jan 16- Feb Grand Total Clinician Visit 311 266 246 241 253 242 1559 Lab Visit 82 87 66 52 37 36 360 Nurse Visit 398 364 276 291 288 287 1904 Grand Total 791 717 588 584 578 565 3823


Refugee Health Services WCHD is responsible for coordinating the delivery of health and health-related services to refugees in the designated service area. WCHD has seen the following number refugees during the current month broken out by gender and year to date (YTD).

Nationality Males Females 2016 YTD 2015 Year Total Burma 4 1 6 98 Burundi 7 1 8 12 Colombia 0 0 0 4 Congo 0 0 1 79 Cuba 3 0 7 16 Eritrea 1 3 5 2 Iran 0 0 0 4 Iraq 2 4 6 51 Rwanda 0 0 0 7 Sudan 0 0 0 1 Syria 0 0 0 35

Dental Sealant Two Dental Providers (OPDS and Onsite Dental) continue to see children and provide sealants from the Dental Sealant Grant.

Month # children served 2015

# children served 2016

# sealants provided 2015

# sealants provided 2016

October 57 25 212 99 November 19 59 84 34 December 34 13 135 50 January 51 80 182 374 February 76 62 286 208 March 64 232 April 48 157 May 65 173

March numbers will be completed once all information is received from Dental Providers for the month of March.

Tuberculosis Care Center Activities

Client(s) Seen New Clients 40

Returning Clients 105 Professional Services

Physician Contacts 25 Medication DOT (direct observed therapy) Visits 7

Diagnostic Servicies Total Active Case(s) in Winnebago County (YTD) 1

Total Actives Case(s) Being Medically Managed Outside of Winnebago County (Ogle) (YTD) 0


University of Illinois - School-linked Health Center University of Illinois College of Medicine (UICOM) noticed Winnebago County Health Department that they would no longer be providing services at the school-linked health center at Blackhawk Park due to low utilization and logistical considerations that would not allow for expansion. Dr. Martell convened a meeting with Rockford Public Schools and Crusader Community Health to review and explore options to address the termination of services by UICOM and evaluate the needs of the community. The anticipated impact is minimal but the group acknowledge the need to consider the expansion of the concept of school-linked health centers to support the health of students, families, staff, and community areas. The group plans to meet again in the next several months.

• Domain 8 – Assure Competent Workforce

March 2016 Total

Employees Full Time

Employees Part-Time and

Seasonal Employees

Employees Utilizing

FMLA

New Hires

Separated Employees

98 92 6 11 1 1

IBCCP (Breast and Cervical Cancer Program) staff attended the annual IBCCP meeting in Springfield, IL. Staff were able to offer feedback on how women are faring in the health care system transition and discuss the impact of the ACA transition on access and service delivery issues. Staff also attended a Pharmacology Update conference sponsored by the Saint Anthony College of Nursing. The quarterly All Staff Meeting and Training was held on March 31st. The meeting included Bloodborne Pathogens training, an overview of the refreshed Strategic Plan as adopted by the Board of Health, and the Local Public Health Systems Assessment in preparation for the Community meetings. Staff self-selected one of the Strategic Plan initiatives that

they would like to work on in the coming year to encourage and engage every level of the organization in fulfilling the goals of the Strategic Plan.


Domain 9 – Quality Improvement

PHAB UPDATE:

1. Pre-application 100% Complete

2. Application 100% Complete 3. Document Selection and Submission

(detailed sub-steps below) 100% Complete

Documents Submitted 100% Complete

Completeness Review Provided 100% Complete

Response to Completeness Review 100% Complete Pre-Site Visit Questions & Request for Additional Documentation 100% Complete

Response to Pre-Site Visit Questions and Requests 100% Complete

4. Site Visit 0% Pending

5. Accreditation Decision 0% Not Started

6. Reports 0% Not Started

7. Reaccreditation 0% Not Started

The PHAB site visit was March 15th & 16th, 2016. PHAB site visitors have two weeks to complete the final report. In approximately 6 weeks, the PHAB Board will review the report and recommendations of the PHAB Site Visit Team to determine accreditation status. The PHAB Board will be meeting on April 27 and May 7th to review. The final decision is communicated to the local health department within 2 weeks of the PHAB Board meeting. WCHD should know our status by mid-May. The determination will be either “Accredited or Action Plan”.

Strengths identified by the PHAB Site Visit Team included: • An active, long-term, engaged Board of Health • The Workforce Development Plan • Support for health equity at the Leadership level • Active collaboration with community partners • Work of the Marketing Committee with the Public Information Officer

Areas for improvement identified by the PHAB Site Visit Team included: • Implementation and monitoring of the community health improvement plan and the

strategic plan • Implementation and monitoring of the Quality Improvement/Performance Management

systems • All documentation need to be clearly dated with documentation of distribution to target

audiences • Challenge of aligning resources including human and financial with community health

improvement plan and strategic plan


• Domain 10 – Evidence-based Practices

The WCHD food staff attended the training, “Team Approach to Foodborne Outbreak Response”, presented by the National Center for Biomedical Research and Training held at the Health Department on March 3rd & 4th. The course identify how skills, resources and expertise of all levels of government can be effectively connected to improve collaboration during a foodborne outbreak. The Shigella Community Task Force was convened as an evidence-based practice to address the ongoing community outbreak of shigella and is highlighted in Domain 2. WCHD Environmental Health Staff participated in the 22nd annual Youth Groundwater Festival at Rock Valley College to provide hands-on science projects to demonstrate the impact of various

factors on groundwater to 4th and 5th grade students from local elementary schools. It was also an opportunity to inform Rock Valley College students of career opportunities in public health.

• Domain 11 – Administration and Management WIC /BBO/ APORS/HRIF

March 2016 FY16

February 2016 FY16

January 2015 FY16

Total FY16 March 2015 FY15

WIC Total Caseload Assigned – SFY15 = 8,359, SFY16 = 7,523

6,030 80%

6123 81%

6306 87%

3,930

6380 76%

FCM (ended 11/30/15) APORS-HRIF/ Healthworks total caseload

233

155

592

3437

2710 106%

Better Birth Outcomes (BBO) Total Caseload Assigned - SFY15 = 120, SFY16 = 90

47 52%

59 66%

71 79%

183

74 62%


The state of Illinois budget impasse continues to impact reimbursement for expenses covered by state of Illinois grants. Advocacy continues through the Northern Illinois Public Health Consortium, Illinois Public Health Association, and Illinois Association of Public Health Administrators but all programs funded through the state of Illinois are experiencing the same issues. A letter to the editor from the Region I Health Departments (Boone, Carroll, Jo Daviess, Lee, Ogle, Stephenson, Whiteside, and Winnebago Counties) was sent out to all of the local media outlets by all counties except DeKalb. Specifics on the media coverage are detailed in Domain 3. Dr. Martell presented to the Heritage Kiwanis of Rockford on the current state of public health in Winnebago County including an overview of the strategic plan, county health rankings, and financing of public health on March 23rd. WCHD staff prepared to implement recommendations adopted by the Board of Health in March to address the budget shortfalls including furlough days the first of which was scheduled for April 1, 2016. Messaging was developed to inform the public.

• Domain 12 – Governance

Multiple “funding bills” have been proposed with the intent of releasing the general revenue funds without enacting a budget. The Governor has indicated that these bills if passed will be vetoed without funding reform. In this context, the legislators have been active in proposing bills in support of policy and language revisions. Legislation is current being reviewed and monitored in Illinois by public health advocacy groups including the Northern Illinois Public Health Consortium, Illinois Public Health Association, and Illinois Public Health Administrators:

Bill Number General Description Public Health Position SB2416/HB6082 ABOLISH STATE BOARD OF HEALTH Oppose SB1584/HB2667 HEAL ACT-BEVERAGES Support HB6027 HEALTHY LOCAL FOOD INCENTIVES Support HB5029 SMOKE FREE-EXEMPTION Oppose HB2404 ELECTRONIC CIGARETTES Support SB3011 TOBACCO AND E-CIG UNDER AGE-21 Support SB2734 MATERNAL AND CHILD HEATLH Support HB5526 MEAT LABELING ACT Oppose HB4592 SCH CD-NO PE WAIVERS Support HB6164 SCH CD-CONTRACTS-PE-DRIV ED Oppose SB2179 AMUSEMENT RIDE-WATER SLIDE Evaluating HB4501 CNTY-CD-LOCAL GOVT REDUCTION Evaluating HB4554 INS-CD PREVENTATIVE HIV DRUGS Support HB5576 INS-CD CONTRACEPTIVE COVERAGE Support HB5736 INS-ALL KIDS REPEAL DATE Support HB5559 MEDICAID ACCESS MONITORING Support HB6213 MEDICAID-PROVIDER DIRECTORY Support HB5671 DHFS-MCO PERFORMANCE METRICS Support SB2213 FOID CARD-MENTAL DISABILITY Support


April 4 – April 10, 2016 is National Public Health Week. We thank our Board of Health, Winnebago County Board, and our community for their support and the commitment and efforts of the Winnebago County Health Department staff to improve the health of Winnebago County.

Respectfully submitted on behalf of the Leadership Team by, Sandra Martell, RN, DNP Public Health Administrator