Report to the Board of Health – February 2016 · Board of Health Report February 2016 - Page 2 of 21 . The EPA strongly recommends that homeowners install radon mitigation in homes

Report to the Board of Health – February 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 2 603 70.4 25.2 0.8 Month Max 2 760 78.0 28.9 1.5 YTD Overall Avg 5 823 ppm 69.9 30.1 0.8 ppm YTD Overall Max 5 2130 ppm 78 F 44.0% 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 2 0 2 0

% of Homes Monitored 0.0% 0.0% 40.0% 0.0% Homes whose overall average exceeds guideline 0 0 1 0

% of Homes Monitored 0.0% 0.0% 20.0% 0.0%

Radon

Phone Calls

Number of Units

Radon Screenings

Average (pCi/L)

Max (pCi/L)

Number of Mitigation

Month 16 4 4 3.0 5.4 1 FY16 to Date 43 11 11 2.0 5.4 2 Program total 84 34 34 4.2 14.0 9

Board of Health Report February 2016 - Page 2 of 21

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. Since the WCHD’s radon screening program began in October 2014, 13 of the 34 homes (38.2%) reported levels above the EPA’s action level of 4.0 pCi/L. Owners of 9 of these homes have reported taking at least some mitigation measures following their screening. Because of the small sample size, no trends or patterns can be determined from the data at this time. Since homeowners self-select for screening, the percentage of homes with high radon levels in Winnebago County cannot be accurately determined. Mosquito Surveillance and Control The WCHD’s West Nile Virus/Mosquito Control program has started organizing a earlier this year than in years past. This has been due to several factors including decreased grant funding, expiration of EPA pesticide permits, and increased public attention to mosquito borne diseases such as the Zika Virus. The WCHD hopes to coordinate mosquito surveillance and control activities with local municipalities in order to efficiently and effectively use resources. As part of the initial assessment, WCHD sent out surveys to the public works departments of all municipalities within the county. The information WCHD obtains from this survey will assist in planning and implementing a county-wide Mosquito Control Response Plan. This plan will establish a protocol for environmental and epidemiological responses when mosquito-borne diseases reach pre-determined thresholds.

Sexually Transmitted Infections

STI Diagnosed in WCHD Clinic YTD 2016

2015 Year Total Cases

2014 Year Total Cases

Syphilis 2 9 5

Gonorrhea 13 75 117

HPV 1 44 111

Chlamydia 29 197 339

HIV 0 2 0


The Communicable Disease Team made up 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.

Illinois Youth Survey ATOD (Alcohol Tobacco, and Other Drug) specialist are following up all schools in Winnebago County to advocate for registering for the Illinois Youth Survey (IYS) which is anticipated to be completed by May 2016. 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 45 schools (34%) are registered to do the survey. WCHD has set a goal of 50% participation and is working with the remaining 30 schools to enlist their participation in the IYS.

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

The Creating Lead Safe Rockford program, working closely with Roman Gray, Winnebago County Purchasing Director, held its annual “Call for Contractors” and bid for work item specifications in February 2016. This bid process included a mandatory pre-bid meeting for all prospective contractors to go over the updated Contractor Handbook and have questions addressed by the CLSR program staff. Bids were due and were opened on February 26th, resulting in the approval of three contracting firms to be used for the last year of the CLSR program. CLSR staff are currently reviewing the bids to establish a set of negotiated prices. If all three contractors accept the negotiated prices, mitigation jobs will be awarded in a round-robin-style system to ensure equity. All award decisions will be reviewed by the Winnebago County Purchasing Department before they are implemented.

Goal Actual Percent Units Enrolled 300 161 53.6 % Inspections 250 144 57.6 % Mitigated Units 225 105 46.6%


Food Complaints

Month FY 2016 FY 2015 # of Foodborne Illness Complaints 3 14 10 # of Foodborne Illness Investigations 3 14 10 # of Non-foodborne Illness Complaints 24 63 60

Housing Complaints

The WCHD’s Neighborhood Code Enforcement program was awarded funds for demolition/deconstruction of blighted properties from the Illinois Housing Development Authority (IHDA) for a second year in a row. This “Blight Reduction Program Round 2” funding totals $840,000—sufficient to demolish a minimum of 24 homes in the greater Washington Park area. This program will build off the current “Round 1” program, which provided $350,000 last year to demolish at least 10 homes in the same area.

Well and Septic Complaints

Original complaints

Recheck complaints

FY16 Original complaints

FY16 Recheck complaints

FY15 Original complaints

FY15 Recheck complaints

Wells 1 3 9 11 2 3 Septic 3 0 11 5 2 4

Communicable Diseases

Vaccine Preventable Diseases (Reporting timeframe)

February 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) 0 0 0 5 7 Hepatitis A (24h) 0 0 0 0 1 Hepatitis B-Acute Infection (7d) 0 0 0 1 2 Hepatitis B-Chronic (7d) 2 0 2 2 28 Hepatitis C-Acute (7d) 0 0 0 1 0 Hepatitis C-Chronic (7d) 17 6 24 239 235 Hepatitis D (7d) 0 0 0 1 1

Month FY 2016 FY 2015 # of Housing Complaints 43 265 256 # of Nuisance Complaints 10 45 49 # of Survey Complaints 63 209 195 # of Received Complaints 107 523 584 # of Re-check on Complaints 308 1656 1758


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) 2 2 2 6 15 Measles (rubeola) (24h) 0 0 0 0 0 Mumps (24h) 0 0 0 0 0 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 0 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) 195 0 256 1751 1702 Gonorrhea (7d) 78 0 93 544 443 HIV infection (7d) 0 0 0 18 18 Syphilis (7d) 1 0 2 11 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 1 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 0 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) 0 0 0 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 0 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) 0 0 0 16 1 Reye syndrome (7d) 0 0 0 0 0 Salmonellosis, other than typhoid (7d) 3 0 4 57 40 Severe Acute Respiratory Syndrome (SARS) (immediate) 0 0 0 0 0 Shigellosis (7d) 16 0 30 116 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) 3 0 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 2 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

* 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:

During the month of February, sixteen (16) additional lab confirmed cases were identified. The disease continues to be community wide. The Communicable Disease Team in conjunction with a University of Illinois at Chicago (UIC) Public Health Graduate Student will be hosting a Community Task Force Meeting on Shigellosis. Since cases of shigellosis continue to be reported, WCHD has invited educators, daycare staff, and medical professionals to attend the Task Force meeting to help end this outbreak. Since young children have represented the majority of the cases, the community’s help is needed to prevent further cases in our daycares, elementary schools and classrooms. A Community Task Force model has been used successfully in other communities to contain shigellosis infections. The meeting details are:

When: Tuesday, March 22, 2016 Time: 8:30 am Where: 555 North Court St. in room 115

This meeting will last approximately an hour. Proposed Agenda:

1. Introductions of attendees 10 min. 2. Presentation on shigellosis outbreak and prevention 15 min. 3. Open discussion 35 min. 4. Future actions 5 min.

The spread of Shigella through the community can visualized in the following bell curve:


2. Zika Virus Disease:

The Communicable 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 providers when both criteria below are met:

• Criteria 1: o Case must have recently traveled to one of the countries or territories

with ongoing Zika virus transmission. And

• Criteria 2 (at least one of the following): o Pregnant females (symptomatic and asymptomatic), o Non-pregnant persons who are symptomatic, or o Fetal ultrasound identifying calcifications of the brain, or microcephaly.

Zika virus disease is caused by a virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are:

• fever, • rash, • joint pain, and • conjunctivitis (red eyes).

The illness is usually mild with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. Once a person has been infected, he or she is likely to be protected from future infections.


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

The Leadership Team at WCHD is also working on the County’s responses to Zika through surveillance, public information on social media and mosquito abatement. While most of the cases of Zika have been “imported”, WCHD is focused on preparing for both imported and local transmission. The Team meets weekly to discuss latest developments and changes in WCHD response.

3. Season Influenza: WCHD is continuing its seasonal influenza surveillance in conjunction with our community partners. The flu has been on the rise 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/about/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. The WCHD Tobacco Coordinator and HP Intern have meet for two (2) weeks with fifteen (15) students from each school. Content covered includes tobacco marketing industry, methods of sales, and development of messages to counteract tobacco industry sales. One “perception of use pre-program survey” was provided to students in health classes in Auburn HS. Results are being tabulated and reviewed by the Tobacco Coordinator and the HP Intern to be used with program content presented to students.

Substance Abuse Youth Prevention Education The ATOD Specialist has been providing prevention education in February to a total of 54 students. The prevention message(s) are delivered in five (5) groups of students a week in the three (3) middle schools. 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 process.

The All Stars Youth Prevention Education is being provided in three (3) Middle Schools in Rockford a total of six (6th and 7th) grade classes and approximately 75-80 students.


Electronic and Social Media Contacts for February 2016

WCHD Website Page 9,910 Page Views 3,304 Sessions 2,556 Users Facebook 60 Avg. Weekly Reach 17 Avg. Weekly Engagements 562 Total Likes Twitter 22.2 K Tweet Impressions 3 New “Likes” 667 Followers

Intranet Page 2,501 Page Views 606 Sessions 387 Users

22nd Annual Youth Ground Water Festival During the month of February, a press release was sent to the media on behalf of the steering committee for the 22nd Annual Youth Groundwater Festival at Rock Valley College. The festival is scheduled for Wednesday, March 9, 2016.

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. 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.

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/


Substance Abuse Prevention Coalition The Winnebago County Youth Substance Abuse Prevention Coalition (WCYSAPC) is currently partnering with the Northwest Community Center to apply for federal funding for strengthening and enhancing the WCYSAPC which will then be able to provide more awareness campaigns, skill building programs, policy development with local leaders, and training of parents and community members to decrease youth substance use and abuse. The Federal Grant is a 5 year grant, $125,000/year. Northwest Community Center will act as the agent managing the coalition with finances, part time staff, and liaison between the federal government and coalition. The grant application is due March 18 and the Coalition will find out in September if their coalition has been chosen to receive the funds. Zalihta will continue to work with coalition members on planning and implementation of coalition goals and objectives regardless of whether the federal funds are received or not. Transform Rockford Dr. Martell continued to represent the Winnebago County Health Department on the Transform Rockford (TR) Healthy Lifestyles Spoke workgroup which presented an overview of the impact statement and strategies at the SecondFirst Church Downtown as part of Faith Communities Dialogue with Transform Rockford Teams. The Faith Communities are meeting weekly through March 30th with various Teams to discuss how faith communities align with the strategies under consideration and what role and/or contributions can the faith community make toward “transforming Rockford”.

Business First

WCHD continues to participate in the BusinessFirst Initiative. In follow up to the February 26th meeting, participating agencies ”brainstormed” for potential 3rd party organizations that would provide an Advisory role to support the coordination of agencies that must permit, license,

and/or inspect businesses. This organization would also assist clients with needed resources, such as, business plan development, financial advice, and guidance throughout the process. In addition, participating agencies have decided to re-evaluate the mission statement and develop a more in- depth survey prior to starting the process to ensure that clients 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 will practice at the All Staff meeting in March, giving the WCHD staff an opportunity to respond to the assessment questions. Smoke Free/Tobacco Free Multi-Unit Housing Policy Development:

• Initiative Goals: Prevent Tobacco Use among youth Promote Tobacco Use Cessation among adults and youth Eliminate Exposure to secondhand smoke Identify and eliminate tobacco related health disparities among specific population groups

February Activities: Tobacco Coordinator visited a number of sites of Winnebago County Housing Authority (WCHA) to determine signage need and discuss signs and policy with facility coordinators.

• Domain 6 – Enforce Laws EHI Code Enforcement Stats

Monthly Inspection

FY 2016 Inspections

FY 2015 Inspections

Foods 352 1540 1599 Wells 10 50 15 Septic 1 35 43 Loan Inspection 41 179 203

Administrative Hearing Month

In-House Hearing Month

Administrative Hearing (FY16)

In-House Hearing (FY16)

FY 2015 Administrative Hearings

FY 2015 In-House Hearing

Housing 6 22 39 124 56 128 Foods 0 1 0 12 0 8 Well/Septic 1 6 2 12 1 6


Report of Food Facility In-house hearings Jobe Japanese Restaurant: 2/16/2016

• Discussed cold holding, thawing, hand washing, proper disposal of mop water, cross contamination of the 3- compartment sink

Pools A meeting was held on February 23rd with the Rockford Park District regarding the safety of their Splash Blaster water coaster. Rockford Park District had not been able to receive a determination from the Illinois Department of Labor (IDOL) regarding the inspection and license of the Splash Blaster. They had had a 3rd party inspection from a nationally known water ride expert to review the structure and operation of the Splash Blaster and had received a report detailing findings and recommendations. WCHD reiterated the importance for us to review these recommendations so we can assist with their corrective action plan. WCHD will follow up with IDOL to determine what authority they have with inspections associated with water “roller coaster” rides. 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

Compliance Check Update on Murphy’s Pub Murphy’s Pub had not implemented all of the actions identified at the site visit and was found to be out of compliance with the SFIA resulting in a SFIA Citation of $250.00. The Citation was paid in February.

Illinois Liquor Control Commission Grant: Tobacco Enforcement Program Working with the Sheriff’s Department, Tobacco Compliance Checks are scheduled to be 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 will be checked on through this operation.


• Domain 7 – Link to/Provide Care iGrow

iGrow – Coordinated Intake for Home Visiting

February 2016 FY16

January 2016 FY16

December 2015 FY16

Total YTD FY16

# CIAT Completed (Coordinated Intake Assessment Tool)

75 111 102 434

# Referred to Partner Home Visiting Programs

6 33 12 95

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. Audio/Vision Program Services for February 2016

Hearing Services Totals Grant YTD

Total Vision Services Totals Grant YTD Total

Screenings 816 2127 Screenings 691 2096

Re-screenings 0 136 Re-screenings 1 168

Referrals 0 0 Referrals 0 32 IPC – Affordable Care Act

The ACA Enrollment Center continued to assist consumers with 2016 open enrollment through the February 15, 2016 grant end date. 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.


Towards the end of the FY2016 grant period, Patient Innovations Center (PIC) approached the Winnebago County Health Department to explore a potential partnership to ensure continuity of client services for ACA enrollment. PIC was one of the recipients of the 3-year Federal Navigator grant and has expressed interest in providing a local presence for enrollment assistance. This is a great opportunity for WCHD to support a program that it cannot sustain. As more information comes available on this potential partnership, additional information will be shared at the Board level.

2016 FY In-person Counselor (IPC) Grant Affordable Care Act (ACA)

Q1: Oct & Nov.

2015

Q2: Dec 2015-

Feb 15, 2015 TOTAL

Appointments: Scheduled 37 125 162

Walk-in 49 227 276

ABE (Medical Card) # Applications Completed 12 106 118

# Applications Started* 4 10 14

Marketplace (Insurance) # Applications Completed 27 115 142

# Applications Started* 6 38 44

Visibility: # Publicized Community Events Held - 2 -

Education: # Educational Presentations Number of Events 70 - 70

Attendance 37 19 56

Outreach: # Community Booths/Tables Number of Events 204 505 709

Attendance 37 125 162

Engagement: One-On-One Stakeholder Meetings 37 49 227

Engagement: One-On-One People Contacts 204 12 106

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.


Illinois Breast and Cervical Cancer Program (IBCCP)

IBCCP has received additional $35,000 in clincal funding to help serve women on priority list. A donation of $1,421 was received from Cliffedge Marketing Group on behalf of "Power of Pink" program which encourages Walmart customers to purchase pink CFL lightbulbs and use them during Breast Cancer Awareness month each October. Proceeds from this program are donated to IBCCP each year. The donation will be used to serve women on our priority list.

Integrated Clinic Services by Visit Type

82%84%86%88%90%92%94%96%98%

100%

Breast CancerScreening Cervical Cancer

Screening

89%88%

10%

0%

0%

0%

Abnormal Screening Follow up Completed YTD Target = 60 Days

Family Planning February 2016

2016 YTD

February 2015

February 2014

Number of Clients Seen 136 285 283 374

New Clients 18 48 45 100

Continuing Clients 118 237 238 274

Pregnancy Tests 65 136 136 230

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

6%8%

30%

15%

% IBCCP YTD Enrollment By Age n=417

Under 35

35-39

40-49

over 50


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 0 0 0 98 Burundi 0 0 0 12 Colombia 0 0 0 4 Congo 0 0 0 79 Cuba 1 2 3 16 Eritrea 0 0 0 2 Iran 0 0 0 4 Iraq 0 0 0 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) had seen a combined 1646 children during the month of February with a total of 53 children receiving 177 sealants from the Dental Sealant Grant. Currently WCHD is working with Rockford Health Council and Dental Sealant Grant Providers to implement a pilot project that would assess the need to develop a dental hygienist as a Community Dental Health Coordinator (CDHC) to work with local dental providers and help navigate with families in need of dental assistance identified through the dental sealant grant activities or dental providers. IDPH would fund the pilot project assessment with federal funds received from HRSA (Health Resources and Services Administration). The Rockford area does have a model that providers are using with great success. The Pilot assessment could help to evaluate the current model and make recommendations for improvements.


Influenza Vaccinations • Flu Shot Billing completed on 100% of community flu clinic participants which included primarily

Medicare recipients, Medicaid, State of Illinois employees, and several small businesses within Winnebago County.

• A total of 2,324 vaccinations were provided by WCHD in community and some employer flu clinics during influenza vaccination season.

• WCHD is developing its Flu Plan for the 2016-2017 Influenza Season. Included as part of the development of this plan is looking at the target populations to be served by WCHD influenza vaccinations, amount of vaccine to order, the continuation of community flu immunization clinics, and the possibility of collaboration with community agencies.

Tuberculosis Care Center Activities for February 2016:

Client(s) Seen New Clients 21

Returning Clients 12 Professional Services

Physician Contacts 16 Medication DOT (direct observed therapy) Visits 10

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

• Domain 8 – Assure Competent Workforce

February 2016 Total

Employees Full Time

Employees Part-Time and

Seasonal Employees

Employees Utilizing

FMLA

New Hires

Separated Employees

98 92 6 8 5 10

Dr. Martell attended training on Radiation Emergency Medicine in Oak Ridge, TN to learn how to address a radiation accident provided through the Radiation Emergency Assistance Center/Training Site (REAC/TS). The course provided an overview of the concepts of radiation physics and radiobiology; training on the use of radiological instruments to detect and measure radiation; control measures to mitigate and contain contamination; and selection of appropriate pharmacologic interventions. Oak Ridge, TN is often referred to as the Atomic or Secret City for its role in the development of materials for the Manhattan Project in World War II.


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% Not Started

5. Accreditation Decision 0% Not Started

6. Reports 0% Not Started

7. Reaccreditation 0% Not Started

Winnebago County Health Department uploaded the response to Pre-Site Visit questions and requests on February 19th, 2016. The PHAB site visit is scheduled for March 15th & 16th, 2016. The site visitors will be preparing a report used by the accreditation board to make their final decision. The final decision is expected 30 days after the site visit.

Domain 10 – Evidence-based Practices

On February 24th supervisors and leadership was offered training on Models of Community Engagement. This training was offered as part of the Winnebago County Workforce Development Plan. This training was offered to improve Community Dimensions of Practice, an area of need for improvement in the 3 tiered workforce development assessment administered to All-staff. The training highlighted the 9 Principals of Community Engagement that have been established by the CDC. The training also emphasized the importance of understanding the different levels of the Social-ecological models and engagement efforts target audience. Nine engagement models were suggested to supervisors, where they were then asked to rank models in a matrix to determine which model best meets department needs.


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

February 2016 FY16

January 2016 FY16

December 2015 FY16

Total FY16 February 2015 FY15

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

6123 81%

6306 84%

6525 87%

1933

6290 75%

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

242/253 =495

592 2560 157%

3204

2721 106%

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

59 66%

64 71%

71 79%

136

77 64%

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 has been drafted informing the public of the overall impact on public health and is under review for release in March.

• Domain 12 – Governance

The Illinois Department of Public Health is pursuing elimination of the State Board of Health as detailed in Senate Bill SB2416 and House Bill HB6042. Failure to pass a budget for the State of Illinois continues to impact programs funded solely with general revenue funds (GRF). The Illinois Public Health Association and other public health advocacy groups have been using the hour glass graphic to emphasize the impact of the budget impasse on Illinois. Respectfully submitted on behalf of the Leadership Team by, Sandra Martell, RN, DNP Public Health Administrator