2013 report to the community health … 2013 report to the community...cross-jurisdictional sharing...

HEALTHDEPARTMENTof Northwest Michigan

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A N T R I M C H A R L E V O I X E M M E T O T S E G O

HEALTH DEPARTMENTREPORT TO THE COMMUNITY2013

OF NORTHWE ST M ICHIGAN


REPORT TO THE COMMUNITY2013Published and Distributed by

THE HEALTH DEPARTMENT OF NORTHWEST MICHIGAN is mandated by the

Public Health Code to promote wellness, prevent disease, provide quality health care,

address health problems of vulnerable populations, and protect the environment for the

residents and visitors of Antrim, Charlevoix, Emmet and Otsego Counties.

OuR MISSION

ANTRIM COuNTY

KAREN BARGYKewadin, Michigan

Program & Evaluation Committee

DAVID HOWELMAN, VICE CHAIRBellaire, Michigan

Personnel & Finance Committee

CHARLEVOIX COuNTY

RONALD REINHARDTBoyne City, Michigan


LARRY SuLLIVANCharlevoix, Michigan


EMMET COuNTY

LARRY CASSIDYBrutus, Michigan


LES ATCHISON, CHAIRPetoskey, Michigan


OTSEGO COuNTY

DOuG JOHNSONGaylord, Michigan


RICHARD SuMERIXGaylord, Michigan


BOARD OF HEALTHHEAlTH dEPARTMENT OF NORTHwEsT MICHIGAN 2013/14

TABLE OF

4 ................................................................................................................... Year in Review

6 ............................................................................................. Family & Community Health

14 ...................................................................................................... Expenses & Revenues

16 ......................................................................................... Grants & Community Support

18 ...................................................................................................... Environmental Health

22 ...................................................................................................... Home Care & Hospice

24 ......................................................................................................... Dental Clinics North

CONTENTS

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Photography................................................................................... M. Chris Leese

Graphic Design .............................................................................. Jennifer Halsey

http://jenhalsey95.wix.com/graphicdesign

ACKNOWLEDGEMENTS

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www.nwhealth.org • 800.432.4121 STAY CONNECTED

REPORT TO THE COMMUNITY2013

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ON THE COVER Northern Michigan teens cool off in summer at the public beach swimming platform in Harbor Springs.

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The Health department of Northwest Michigan is mandated by the Public Health Code to promote wellness, prevent disease, provide quality health care, address health problems of vulnerable

populations, and protect the environment for the residents and visitors of Antrim, Charlevoix, Emmet and Otsego Counties.


YEAR IN REVIEW

Joshua Meyerson, MD, MPH Medical Director

Linda Yaroch, RN, MPH Health Officer

On behalf of the Board of Health and our many dedicated staff members across Antrim, Charlevoix, Emmet and Otsego

Counties, the Health department of Northwest Michigan is pleased to submit this Report to the Community to you – our residents, community

partners, fellow agencies, state and local leaders, charitable contributors, grantors and volunteers. You are all stakeholders in our mission, and we hope this Report reflects the tremendous

community benefit we are able provide, thanks to your support.

CROSS-JuRISDICTIONAL SHARINGNorthern Michigan’s economic climate, geography and widely-dispersed population present unique challenges for Health department programs and services. Chronic disease is on the rise, while program funding continues to decline.

To overcome these challenges, we are looking beyond jurisdictional boundaries to share regional resources, and taking advantage of new opportunities presented by advances in technology and health care. The Robert wood Johnson Foundation has awarded the Health depart-ment of Northwest Michigan a two-year, $125,000 grant to explore cross-jurisdictional sharing arrangements among six Northern Michigan health departments, which include the Benzie-leelanau district Health depart-ment, Grand Traverse County Health department, and district Health department Nos. 2, 4 and 10. Together, our six local health departments are evaluating possible alliances to share services, programs and capacities. Our objective is to increase efficiency and to build public health capacity across Northern Michigan.

The Northern Michigan Cross-Jurisdictional sharing Team consists of Health Officers and Board of Health members from each of these health districts, as well as our community partners, including the Michigan department of Community Health, Munson, Mclaren Northern Michigan and the University of Michigan school of Public Health. This team is part of the 17 communities across the country that comprise the shared services learning Community, which provides access to national experts in financial and legal analysis, operations, management, quality improvement, community engagement, communications and evaluation.

DISTRICT HEALTH DEPARTMENT #2


HEALTH DEPARTMENT OF NORTHWEST MICHIGAN

GRAND TRAVERSE COUNTY HEALTH DEPARTMENT

BENZIE-LEELENAU DISTRICT HEALTH DEPARTMENT


Cross-jurisdictional sharing arrangements range from informal agreements around sharing individual services, to full regionalization, including formal consolidation of multiple local health departments. Mater-nal health, child health and information technology are the top priorities of our Cross-Jurisdictional shar-ing Team. The Robert wood Johnson Foundation will use lessons we learn to provide guidance to public health agencies considering cross-jurisdictional sharing.

Major grant activities include thorough assessment of the cross-jurisdictional sharing arrangements in place, development a cross-jurisdictional strategic plan, assessments of each local health department’s capacity to implement the 10 Essential Public Health services, and the possibility of a voluntary, multi-juris-dictional application to the national Public Health Accreditation Board.

AFFORDABLE CARE ACTThe Affordable Care Act, and the rollout of the Health Insurance Marketplace, placed great responsibility on the shoulders of local public health departments and health centers throughout the state. Amid wide-spread public controversy over the ACA and the troubled HealthCare.gov rollout, the Health department of Northwest Michigan assumed a leadership role in helping residents from all eight tip-of-the-mitt counties get enrolled in the Marketplace.

With a trained Lead Navigator and several Certified Application Counselors among our Health Depart-ment staff, we joined forces with district Health department No. 4 and other regional partners to provide public education and enrollment assistance. Together, we offered group workshops, small business forums and one-on-one assistance that reached thousands of Northern Michigan residents. we will be prepared to offer Marketplace assistance again when enrollment reopens each fall.

As 2013 drew to a close, we looked ahead to April 2014, and the rollout of the Healthy Michigan Plan. The Plan is now in effect, covering services for many who don’t qualify for health insurance under the Market-place, and it includes dental benefits that are a significant asset to our Dental Clinics North patients who are 19 to 64 years of age.

LEADERSHIP CHANGESFor more than 30 years, Christie Vogelheim has provided administrative leader-ship and support to the Health department of Northwest Michigan. Christie an-nounced her retirement from her position as director of Administrative services at the end of 2013. she has earned the lasting respect of her many colleagues and friends among the staff at the Health department, and also among the community and business partners with whom she worked closely. Christie’s forward-thinking, steady guidance has enabled the Health department to stay in step with growing needs for its services, while always being a faithful to its mis-sion. she is deeply missed, but she travels with our best wishes for a long, happy and healthy retirement.

we’re pleased to welcome Bradley Rider as the Health department’s new director of Administrative services. A native of southeast Michigan, Bradley and his family have now lived in Northern Michigan for more than 15 years. He holds a degree in Finance from Michigan state University, a Master’s degree in Busi-ness Administration from wayne state University, and has extensive manage-ment experience in the banking and health care fields. He served most recently as CEO of Bay street Orthopaedics for the past eight years. Brad oversees our finance, human resources, information technology, facilities and communica-tions functions within the agency.

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AT THE HEARTOF THE MATTER

Nguyen duyen was just 16 when she left her home in Vietnam to spend a year in the United states, as part of a sponsored exchange program. she found herself in Northern Michigan, living with a host family in Mancelona, where she was also to attend school.

Just a few weeks after her arrival in the states, Nguyen needed a physical exam to meet school requirements. she went to the Ironmen Health Center, a school-linked child and adolescent health center in Antrim County, oper-ated by the Health department of Northwest Michigan. Though it was a routine exam, her clinician, Tammy Hick-man, detected something out of the ordinary.

“It was a heart murmur, one that had never been discovered until that day,” Tammy recalls. “Nguyen’s English language comprehension was fair, but her speaking skills were poor. Her parents in Vietnam spoke no English. But we had to communicate with them about this potentially life-threatening health issue.” The Ironmen Health Center worked with Nguyen’s Mancelona host family and screening centers, to provide interpreters during her screening and evaluations.

Nguyen was referred to Mclaren Northern Michigan, in Petoskey, for a student heart screening that is offered to students in grades 9 through 12. After electrocardiogram and echocardiogram testing, and a consultation with a cardiologist, Nguyen was diagnosed with an Atrial-septal defect (Asd) - a hole in the wall between the top two chambers of the heart – which can lead to complications and, eventually, heart failure if not treated when the patient is young.

Unfortunately, following the discovery of Nguyen’s heart defect, the company that sponsored her U.s. exchange withdrew its coverage, and stated that she needed to return to Vietnam.

Meet the Health Department’s Emmet County Family & Community Health Staff

(From left to right): Melissa Mundy, RN, MPH, Family & Community Health Nurse, Nanette Graham, RN, Family & Community Health Nurse, Keri Vigneau, Public Health Technician, Sheryl Green, Public Health Technician, Cindy Kloss, RN, BSN, County Coordinator, Carol Francis, RN, Family & Community Health Nurse, Debra Pluim, RN/CNM, Nurse Practitioner, Patricia Fralick, RN, BSN, MBA, Director, Family & Community Health, Mary Martinchek, RN, BSN, Family & Community Health Supervisor

CElEBRATING FAMIlY & COMMUNITY HEALTH

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That’s when Mclaren referred Nguyen to C.s. Mott Children’s Hospital in Ann Arbor, where her Asd was declared to be “significant” but correctable. Her doctors felt that she needed charitable care and, thanks to the hospital and the International Children’s Fund, her heart surgery was fully covered. she was able to return to Northern Michigan for cardiac rehabilitation in Petoskey at no charge.

Nguyen’s mother had flown in from Vietnam to be with her daughter during and after the surgery. They later returned to visit clinician Tammy Hickman at the Ironmen Health Center, along with Nguyen’s host family, and all were elated by the successful repair of the life-threatening heart defect Tammy had detected.

“Effective coordination between our child and adolescent health center, the host family, and the two medical centers made this positive outcome possible,” Tammy says. “Nguyen can now look forward to a full and healthy life. This is why we do what we do.”

IroNMEN HEaltH CENtEr: 1,390 VISItS SErVING 505 StudentS age 10-21

HorNEt HEaltH CENtEr: 1,456 VISItS SErVING 418 StudentS age 5-21

BoyNE CIty SCHool WEllNESS ProGraM: 1,704 VISItS SErVING 535 StuDENtS

SCHool-BaSed ServiCeS

The Health department’s child and adolescent health centers, which include the Hornet Health Center in Pellston and the Ironmen Health Center in Mancelona, provide primary care and mental health services on school campuses. The Boyne City school wellness Program, launched in 2011, includes nursing services, group and individual health education, school staff training, and mental health services for elementary and middle school students.

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MATERNAL INFANT HEALTH PROGRAM AND NEWBORN HOME VISITS 8,759 HoME aND oFFICE VISItS 6,336 NEWSlEttErS SENt to FaMIlIES WItH youNG CHIlDrEN

Women, infantS and CHildren (WiC) NutrItIoN ProGraM 3,170 WIC PartICIPaNtS

The wIC Program protects the health of low-income pregnant women, as well as their infants and children up to age 5, who would otherwise be at nutritional risk. The program provides nutritious foods, information on healthy eating, and referrals to health services within the community. wIC food packages are valued at more than $60 per month, and include infant formula, cereal, milk, eggs, cheese, juice, fresh fruits and vegetables, and peanut butter. Breastfeeding peer support is also available.

• Every dollar spent on WIC saves more than $3.50 in subsequent health care costs.

• Pregnant women served by WIC enter prenatal care earlier. • Women enrolled in WIC deliver fewer low birth-weight infants. • Children served by WIC are less likely to be anemic, and are more

likely to receive proper health care & immunizations.

Early CHIlDHooD BEHaVIoral HEaltH INItIatIVE 16 FaMIlIES SErVED 186 PartICIPaNtS IN ParENt NEtWorKING NIGHtS

The Early Childhood Behavioral Health Initiative seeks to establish and sustain a supportive family network to promote social and emotional development, and to enhance behavioral health services for young children age 0-5 in Charlevoix, Emmet and northern Antrim Counties. six successful Parent Networking Nights were held during 2013; these provided parents of young children with a free evening of dinner and child care while meeting other parents and learning about helpful parenting and child development resources. Ages & Stages developmental screening was added to the Health department’s web site at www.nwhealth.org/agesandstages. The Initiative offers support to all parents, regardless of income or insurance status.

FluorIDE VarNISH aPPlICatIoNS 2,394 aPPlICatIoNS Fluoride varnish is a protective coating that fights tooth decay, one of the most common and preventable diseases in chil-dren. The coating is painted on teeth to help prevent new cavities, and to stop cavities that have already begun to form. The coating attaches easily to the teeth, and makes tooth enamel harder. Fluoride varnish applications are available to children participating in wIC, which included 1,261 children in 2013.

CElEBRATING FAMIlY & COMMUNITY HEALTH PROGRAMS

The Health department’s Maternal Infant Health Program (MIHP) assists families with pregnant women or infants by providing information on pregnancy, preparing for the baby, infant care, infant feeding and parenting through a team that includes nurses, social workers and registered dieticians. Families that participate in MIHP are less likely to have low birth-weight infants. during Newborn Home Visits, Health department nurses check the baby’s weight, provide breastfeeding support, answer questions and provide important information on caring for a new baby.

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CElEBRATING FAMIlY & COMMUNITY HEALTH PROGRAMS

The Children’s special Health Care services program covers specialty medical care and equipment costs for families with a child who has a chronic health condition. Nurses and program representatives also connect families with community services, medical equipment, a parent hotline, and travel and lodging assistance for medical appointments.

1,784 pre-SCHool CHildren SCreened

HEarING aND VISIoN SCrEENING9,576 SCHool-age CHildren SCreened

736 CHIlD rEFErralS For trEatMENt

The Health department provides childhood hearing and vision screen-ing to help prevent delays in the development of speech, language and social skills, which can impact academic performance. Hearing and vision screening identifies problems that would otherwise go undetected, and connects children with essential health care resources before further hearing or vision loss can occur.

CHIlDrEN’S SPECIal HEaltH CarE SErVICES

935 CHIlDrEN SCrEENEDBlooD lEaD SCrEENINGThe Health department screens children for exposure to lead, which can damage the nervous system, kidneys and blood, and is particularly harmful to the developing ner-vous systems in fetuses and children under six years of age. Common sources of lead exposure in children are house dust contaminated by lead-based paint, and soil con-taminated by leaded paint or decades of industrial and motor vehicle emissions.

516 PartICIPaNtS


PatIENtS ratE tHEIr ClINIC EXPErIENCEWRITTEN MATERIALS HELPFUL

STAFF HELPFULNESS “EXCELLENT”

STAFF ATTITUDE “EXCELLENT”

APPOINTMENT TIME CONVENIENT

“Everyone was very helpful, and they had wonderful resources.”

“I got in fast, and things were explained well.”

“friendly staff, helpful information.”

“Everyone is willing to do whatever they can to help.”

50% 60% 70% 80% 90% 100%

91%94%

96%

99%

“this program and these people are excellent.”

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THE MEANs TO SuRVIVEMary Everett of Central lake had already survived breast cancer once. she knew the importance of regular

mammograms, and continued getting them. “I didn’t believe I’d get it again,” she recalled.

But in February 2013, Mary, 62, received the terrifying news that another small tumor had been found. she did not feel the lump. she had no health insurance, and was referred to the Health department of Northwest Michigan’s Breast and Cervical Cancer Control Program (BCCCP) for assistance.

The Health Department partners with Antrim County High Tea – a nonprofit organization dedicated to helping eligible Antrim County women get the preventive services they need – to provide screening and follow-up, at no charge. Antrim County High Tea also covers transportation costs by providing gasoline cards through the Health department.

BrEaSt aND CErVICal CaNCEr CoNtrol ProGraM1,328 Women SCreened, inCluding 829 from four-County HealtH diStriCt

The Health department provides low-income, uninsured women with free breast and cervical cancer screening, including mammograms. This provides an opportunity to identify cancer at the earliest possible stage, when it is most treatable. If a woman is diagnosed with breast cancer, enrollment in the Medicaid Treatment Act covers costs related to treatment.

well-Integrated screening and Evaluation for women Across the Nation, or wIsEwOMAN, screens low-income, uninsured or under-insured women age 40-64 for heart disease and stroke risk factors, such as nutrition, physical activity, stress and tobacco use. The Health department’s Public Health Nurses provide counseling and referrals to help clients meet health improvement goals.

ColorECtal HEaltH SCrEENING ProGraMColorectal cancer is the second leading cause of cancer death in the United states. It is also a cancer that is fully pre-ventable with screening. That’s why the Health department provides uninsured or under-insured women and men, age 50-64, with an at-home screening test that is then analyzed at the Health department’s Northern Michigan Regional laboratory, and with free colonoscopies if program criteria are met.

FaMIly PlaNNING ProGraMThe Health department’s Family Planning services help men and women make well-informed reproductive health choices, so they can plan for a healthy pregnancy or prevent an unwanted pregnancy. services include a health his-tory, physical exam, counseling on birth control methods, dispensing of contraceptives such as pills, depo shots and nuva rings, and medical follow-up when abnormalities are discovered in the reproductive system.

570 PartICIPaNtS

183 ClIENtS SCrEENED

1,140 PartICIPaNtS

WISEWoMaN ProGraM


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Mary underwent a lumpectomy, lymph node removal and four months of chemotherapy during 2013, and has completed her radiation treatment. she said the early detection of her tumor offered her an excellent chance at recovery, and is grateful for the Health department’s help in getting insurance to cover her treatment. “without it, I would not be able to afford to get treated,” she said, adding that she had to make frequent trips between Central lake and Petoskey for treatment. “The gas cards are a great help.”

MICHIlD, HEaltHy KIDS aND PlaN FIrSt!

CoMMuNICaBlE DISEaSE INVEStIGatIoN

The Health department investigates all reportable communicable diseases in Antrim, Charlevoix, Emmet and Otsego Counties. These include such diseases as hepatitis, giardiasis, meningitis, salmonellosis and sexually-transmitted diseases. Interviews are conducted with infected individuals, and also with family, friends, co-workers and others who may have been in contact and are at risk. Health educa-tion and treatment is provided, if needed, to prevent the disease from spreading.

IMMuNIzatIoNS

Immunizations prevent diseases that can be dangerous – even deadly – by helping the body safely develop immunity to disease. The Health department administers and distributes vaccines to prevent the spread of polio, measles, mumps, rubella, influenza, tetanus, diphtheria, chicken pox, meningitis, whooping cough and other communicable diseases. Immunizations are provided in the wIC Program and at the Hornet Health Center, Ironmen Health Center, Health Department office clinics, or in other community locations, such as schools.

198 CoMMuNICaBlE DISEaSE INVEStIGatIoNS, 199 SEXually traNSMIttED DISEaSE INVEStIGatIoNS

12,791 DoSES aDMINIStErED, 17,265 DoSES DIStrIButED

MIChild and Healthy Kids provide pregnant women and children up to age 19 with health insurance coverage through the state of Michigan. MIChild provides a Blue Cross/Blue shield policy for just $10 per family per month, while Healthy Kids provides free health insurance for those who qualify. Plan First! enrollment provides coverage for reproductive health exams and supplies for women ages 19-44. The Health department works with clients to guide them through the enrollment processes of these complex but highly beneficial resources.

Through the Northern Health Plan, a community partnership of hospitals and health departments, 3,000 uninsured adults were provided a plan to help them access care.

667 ClIENtS aSSIStED

Mary has some advice for those who may be hesitant about getting a mammo-gram. “don’t put it off!” she said. “The ear-lier you catch it, the easier to treat it… so many people I know have experienced it. My sister Nancy had it and survived. I was her support, and now, she’s mine.”

To learn more about the Health depart-ment’s Breast and Cervical Cancer Control Program and its partnership with Antrim County High Tea, or to learn how you can support both organizations, visit www.nwhealth.org or www.antrimcountyhightea.org.

Mary receives a gasoline credit card from Joy Klooster, RN, BSN, MBA (left), the BCCCP Coordinator, to help with the cost of her travel to and from her follow-up appointments.

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toBaCCo PrEVENtIoN ProGraMThe Health department of Northwest Michigan works closely with schools in Antrim, Charlevoix, Emmet and Otsego Counties to develop policies and plans that support a healthy learning environment. By the end of 2013, one hundred percent of all school districts in the Health department’s four-county region had enacted 24/7 tobacco-free policies.

In addition to working with school districts, the Health department focused its efforts on enacting smoke-free and tobacco-free policies at public parks and beaches. The number of tobacco-free parks and beaches in the region jumped from one (1) to six (6) during 2013 alone. They include parks owned by the Village of Pellston, and the Petoskey Youth soccer Association soccer complex, an outdoor space with 14 soccer fields for youth and their families.

PARTNERING TO BUIldHEALTHY COMMuNITIES


FARM FRESH21 FarMEr’S MarKEtS IN BoyNE CIty, CHarlEVoIX, GaylorD aND PEllStoN

FarMEr’S MarKEtS MorE tHaN 4,000 VISItorS to HEaltH DEPartMENt FooD StallS

Farmer’s markets are a popular Northern Michigan destination in the spring, summer and fall. They’re a great source of healthy, locally-grown produce. But with the help of the Health department, local farmer’s market managers, and the UsdA’s supplemental Nutri-

tional Assistance Program (sNAP), several local farmer’s markets can now also accept a cash alternative from low-income individuals and families in the region who purchase food using sNAP Bridge Cards. The sNAP Bridge Card is an electronic balance transfer (EBT) card that can be used by those in the sNAP pro-gram to shop for certain kinds of healthy food at a participating location. These include breads and cereals, fruits and vegetables, meats, fish, poultry, and dairy products – items that are healthy for the entire household.

The Health department has partnered with farmer’s markets in Antrim, Charlevoix, Emmet and Otsego Coun-ties to promote acceptance of the sNAP Bridge Card. what’s more, when cardholders make purchases through certain participating markets, the amount of money they spend is matched with “double-Up Food Bucks”, enabling them to buy even more Michigan-grown fruits and vegetables.

during 2012, only three Northwest Michigan farmer’s markets had the ability to accept Bridge Cards, and their total sales through the program were about $600. But in 2013, thanks to grants from the wIsEwOMAN Program, the Michigan Cancer Consortium, the Michigan Nutrition Network, and the Michigan department of Community Health, the Health department was able to offer technical assistance to market managers and

HEAlTHY PROdUCE FROM lOCAl FARMER’s MARKETs NOw IN EAsY REACH FOR lOw-INCOME INdIVIdUAls ANd FAMIlIEs

SaFE youth from Charlevoix and Emmet Counties promote a Substance abuse-Free Environment

(SaFE).

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KIDS IN tHE KItCHEN A 7-session nutrition education

program with cooking instruction was completed with two groups

of middle school students in the summer. The children really enjoyed the program,

learning how to cook and trying new foods; they often commented they were excited to make the dish at

home with their families!FarMEr’S MarKEt CooKING DEMoS

SaFE routES to SCHoolThe Health department worked with the Boyne City, East Jordan, and Pellston schools on the safe Routes to school Program to assess the built environment, as well as attitudes and behaviors, that can en-able students to actively commute to school. City leaders, school ad-ministrators, parents, and students participated in planning meetings to create action plans and special events for students to walk or bike safely to school rather than riding in a bus or car. The action plans will be used by city officials, school administrators, and the Health De-partment to write federal grant applications to support infrastructure changes to create safe, walkable, bikable communities for students.

750 StuDENtS aND 1,800 aDultS rEaCHEDMorE tHaN 100 StuDENtS aND aDultS INVolVED IN CoalItIoN WorK

18 oF 18 loCal SCHool DIStrICtS NoW 100% toBaCCo FrEE!!!

SuBStaNCE aBuSE PrEVENtIoN

The Health department’s substance abuse prevention programs are research-based, and are considered best practices for preventing the abuse of drugs, alco-hol, tobacco and other substances. Preventing abuse among adolescents means preventing a lifetime of health and social problems. substance abuse leads to suicide, early and unsafe sexual activity, and motor vehicle accidents. The Health department educates students within the classroom and adults throughout in the community on the dangers of alcohol, tobacco, prescription drugs, and other drugs.

launch major outreach and awareness efforts, including direct mailings and media coverage. As a result, a total of six markets were approved to accept the Michigan Bridge Card in 2013, and three markets received double-Up Food Bucks funding. sales to sNAP participants grew to a whopping $12,227 for the period be-tween June and september. Total sales for calendar year 2013 are estimated to be approximately $13,000.

The success in sNAP produce sales, combined with other major successes at farmer’s markets in Northwest Michigan, had a snowball effect in securing the approximately $140,000 in grants received by the Health department. Funds were used to help farmer’s markets implement EBT card reader technology and dou-ble-Up Food Bucks, to conduct widespread marketing and outreach activities, to provide stipends to local markets for staffing the EBT/Double-Up Food Bucks booths, to provide funding for EBT machine maintenance,

and to provide nutrition education at four different farmer’s markets in the region. These efforts led to an overall increase in awareness of sNAP, double-Up Food Bucks, and sNAP-Ed activities.

Amy Brown and Lynne DeMoor provide a cooking demonstration at the Boyne City Farmer’s Market.

DENTAL CLINICS NORTH$10,172,132

FAMILY & COMMuNITY HEALTH$6,460,830

ENVIRONMENTAL HEALTH

HOME CARE& AGINGSERVICES

$2,149,111 OTH

ER $

656,

468

$1,714,216

REVENuES

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EXPENSES &

EXPENSES BY PROGRAM

TOTAL: $21,152,757

$1,282,576

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TOTAL: $20,886,612

FEES & COLLECTIONS$12,376,189

STATE & FEDERAL FuNDS$7,303,284

COMMuNITY GRANTS $248,459

LOCAL A

PPROPR

IATIO

NS $958,680

REVENuESThe Health Department invests carefully in services that benefit

every part of your community.

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COMMuNITY

GRANTS &

SuPPORTTHE HEALTH DEPARTMENT OF NORTHWEST MICHIGAN

is grateful for the support we received from community organizations and our community partners during 2013.

Your generosity makes it possible for us to sustain and expand the kinds of programs that make Northwest Michigan

a healthy place to live, work and visit.

Health Department of Northwest Michigan Headquarters—Charlevoix County

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antrim County High tea 2013 aBC Challenge Walk

aNtrIM CouNty HIGH tEa For BrEaSt CaNCEr PrEVENtIoN

partners with the Health Department to ensure every woman in Antrim

County has full access to mammography services and

follow-up treatment.

left to right: terri Vanuum, Chris Hale, Marilyn McClure, Dee lynch, Gerald DeGrazia, Jane VanEtten, Janna Gates, ann Schwandt & Jami Gray.

Antrim County High Tea for Breast Cancer PreventionBellaire Lioness ClubChar-Em united Way

Charlevoix Area HospitalCharlevoix County Community Foundation

Charlevoix Women’s CircleChrist Child Society

Delta Dental of MichiganEast Jordan Lions ClubElk Rapids Lions ClubEllsworth Lioness Club

Frey Foundation

Jane Dinser, Office Coordinator,HDNW Antrim County

Connie Birdsall, Office Coordinator, HDNW Charlevoix County

Megan robinson, Office Coordinator, HDNW Emmet County

Nicole Spires, Office Coordinator, HDNW Otsego County

Health department of Northwest Michigan—Antrim County

Health department of Northwest Michigan & dental Clinics North—Harbor springs, Emmet County

Health department of Northwest

Michigan—Charlevoix County

Health department of Northwest Michigan & dental Clinics North—Gaylord, Otsego County

Little Traverse Bay Bands of Odawa IndiansMcLaren Northern Michigan

Michigan Department of Community HealthMichigan Department of Education

Michigan Fitness CouncilNorthern Health Foundation

Northern Health PlanOtsego Memorial Hospital - Gaylord

Petoskey - Harbor Springs Area Community FoundationRally for the Cure

Robert Wood Johnson FoundationZonta International

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100

80

60

40

20

0

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MBE

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MPL

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EXCEPTIONALEVEN UNdERMEETING

RADON HEAd-ONMore than 21,000 Americans are killed each year by radon-induced lung cancer. Radon is a radioactive

gas that comes from decaying radium and uranium occurring naturally in the earth, and it is detected often in homes throughout Northern Michigan. It is the second leading cause of lung cancer overall,

and is the leading cause of lung cancer among non-smokers. Radon is odorless and invisible, so the only way to know if your home has a prob-lem is to test for it. levels of the gas can vary greatly from one home to the next, but they are generally highest in homes that are closed up tightly, with little ventilation – such as during a long Northern Michigan winter.

Bill dietrich has been a real estate professional in Northwest Michigan for more than 40 years, working with home buyers, sellers and inspec-tors every day. He finally decided to test his own home in Charlevoix for the presence of radon. He picked up one of the Health department’s complete do-it-yourself test kits, and to his surprise, he discovered radon levels in his home exceeding the EPA’s recommended action level.

“My wife and I were very concerned about the results, and wanted to know what we could do to resolve the problem,” dietrich said. “The

THE HEAlTH dEPARTMENT HElPs NORTHERN MICHIGAN HOMEOwNERs ANd BUsINEss OwNERs lIKE BIll dIETRICH UNdERsTANd, dETECT ANd ElIMINATE A sIlENT KIllER: RAdON.

RADON TESTS

COMPLAINT INVESTIGATIONS

MORTGAGE EVALUATIONS

EXISTING SYSTEM EVALUATIONS

LAND EVALUATIONS ANTRIM (145) CHARLEVOIX (81) EMMET (110) OTSEGO (140)

RESIDENTIAL SERVICES

46

513

31

8

48

37

116

313 15

4

18

totalSRADON TESTS: 186

COMPLAINT INVESTIGATIONS: 64MORTGAGE EVALUATIONS: 52

EXISTING SYSTEM EVALUATIONS: 116LAND EVALUATIONS: 58

30

42

9

18 17

1 2

PROTECTING & PROMOTING ENVIRONMENTAL HEALTH

REPORT TO THE COMMUNITY2013 P19


Health department was helpful in providing information and guidance as to what this meant, and what to do next.” After some further testing, Dietrich contacted a certified radon contractor, who was able to correct the high radon level his home with radon mitigation equipment. “The equipment was installed in one day, and has been effectively eliminating radon from our home for the past seven-plus years,” he said, adding that follow-up tests have shown his home to have radon levels at or below those found in normal fresh air.

dietrich says a large number of home buyers and sellers are not aware of the risks posed by radon. “I would recommend to buyers that they make radon testing part of their home inspection, or do it independently with the Health department,” he said. “Everyone should be informed and aware that elevated levels of radon in a home can be fixed – not only for sale purposes, but for the health and wellbeing of the homeowner and family living in the home.”

Radon test kits are available for just $15.00 through the Health Department of Northwest Michigan’s offices in Bellaire, Charlevoix, Gaylord and Petoskey/Harbor springs.

Charlevoix-area real estate agent Bill Dietrich was surprised to discover high levels of radon in his own home. With help from the Health Department and a licensed contractor, Bill and his wife can now rest assured that their home is free of harmful radon levels.

FULL SERVICE FOOD LICENSE

LIMITED FOOD SERVICE LICENSE

TEMPORARY FOOD LICENSE

MOBILE/TRANS/EXEMPT/C&C

VENDING/STFU

NU

MBE

R IS

SUED

ANTRIM (162) CHARLEVOIX (245) EMMET (265) OTSEGO (168) total 840

FOOD LICENSING150

120

90

60

30

0

139

3 12 1 2 12

73

31

43

95

55

79

63

49

85

41

26

215 14

totalSFULL SERVICE FOOD LICENSES: 392

LIMITED FOOD SERVICE LICENSES: 190TEMPORARY FOOD LICENSES: 197

MOBILE/TRANS/EXEMPT/C&C: 8VENDING/STFU: 53

Ron Boss

PuBLIC BATHING BEACH SAFETY MONITORING The Health department’s Bathing Beach safety Monitoring Program moni-tored the water quality at 50 beaches throughout Antrim, Charlevoix, Emmet and Otsego Counties during 2013.

For more than a decade, water quality monitoring has covered 31 lake Michigan beaches in the region. This important work was made possible through grant funding from the United states Environmental Protection Agency (EPA) and the Michigan department of Envi-ronmental Quality (MdEQ). Those who live on or near the lake, and seasonal tourists who visit and enjoy Northern Michigan’s unspoiled beaches, have come to trust that the water quality is being moni-tored for their safety. The monitoring program has been successful in protecting public health, and has also supported the economic benefit of having clean, safe swimming areas.

Unfortunately, due to severe EPA funding cuts, the Health department will not be able to continue comprehensive sampling of these Great lakes beaches without financial assistance. The agency is reaching out to individ-ual beach operators, offering a fee structure to continue beach water quality sample collection and analysis, posting of beach water quality information on the state’s publicly-accessible water quality website, and complete handling of any necessary advisories, closures and follow-up sampling. water quality samples continue to be tested through the Health department’s Northern Michigan Regional laboratory, a laboratory with the ability to analyze samples at a very low cost and provide results quickly.

The Health department holds primary responsibility for the surveillance, investigation and prevention of waterborne illness in Northwest Michigan, and is committed to the protection of ground and surface waters. It is also responsible for inspecting, permit-ting and conducting investigations of public and private wastewater systems. Clients include schools, day care facilities, restaurants, churches, businesses, private homes and many others.

P20




PROTECTING & PROMOTING ENVIRONMENTAL HEALTH

RESIDENTIAL WELL PERMITS (462 TOTal)

PUBLIC WATER SUPPLY PERMITS (33 TOTal)

total 495ANTRIM 143CHARLEVOIX 109EMMET 141OTSEGO 102

WELL PERMITS150

120

90

60

30

0

NU

MBE

R IS

SUED

133

10

103

6

128

13

98

4

ANTRIM CHARLEVOIX EMMET OTSEGO

total 50

BACTERIOLOGICAL WATER SAMPLES (1,197)

PARTIAL CHEMICAL WATER SAMPLES (898)

The Northern Michigan Regional laboratory serves a 19-county region from its location at the Health department facility in Gaylord. In partnership with the Michigan departments of Community Health and Environmental Quality, the lab provides timely, accurate water analyses to serve public health, clinical and epidemiological needs.

water samples for testing can be dropped off at the Health department’s facilities in Bellaire, Charlevoix, Gaylord and Harbor springs.

WATER TESTING AT THE NORTHERN MICHIGAN REGIONAL LABORATORY


166142 146

118

344

243

375

541

ANTRIM

CHARLEVOIX

EMMET

OTSEGO

COMMERCIAL ENVIRONMENTAL SERVICES60

50

40

30

20

10

0

NU

MBE

R PR

OVI

DED

20

42

55

21

20 1 0

2420 18

34

15 149

151314

24

46

SWIMMING POOL LICENSES

SUBDIVISION/ SITE CONDOS

DHS FACILITIES

CAMPGROUND LICENSES

SEPTIC WASTE HAULER LICENSES

The Health Department values its positive working relationships with local residents,

business owners & contractors.

P21



SEWAGE & SEPTIC SYSTEMS

NEW SEWAGE PERMITS (279 TOTal)

REPLACEMENT SEWAGE PERMITS (289 TOTal)

ALTERNATE SYSTEMS (19 TOTal)

120

100

80

60

40

20

0

NU

MBE

R IS

SUED


total 576ANTRIM 182CHARLEVOIX 147EMMET 144OTSEGO 103

70

111

12

75

67

5

109

33

2

25

78

0

totalSSWIMMING POOL LICENSES: 138SUBDIVISION/SITE CONDOS: 3

DHS FACILITIES: 96CAMPGROUND LICENSES: 53

SEPTIC WASTE HAULER LICENSES: 97

total 2,383ANTRIM 308CHARLEVOIX 572EMMET 587OTSEGO 916

CARE COMEsPERSEVERANCEwhen dean Johnston was admitted to the hospital in the fall of 2013, he didn’t expect to make it out alive.

The 68-year-old engineer and Vietnam veteran suffered from advanced lymphoma and pulmonary fibrosis, leaving him with debilitating shortness of breath and activity intolerance. He was referred for hospice care

through Hospice of Northwest Michigan.

while hospice provides end-of-life care for the terminally ill, hospice care nurses explore every opportunity to im-prove the quality of life for their patients. In dean’s case, nurse Patty Frederick worked with dean and his physician to establish a regimen that offered him a chance to stabilize his health and living conditions. In fact, he worked so hard to follow Patty’s guidance that he was able to “graduate” from active terminal status to a functional lifestyle.

“I was fortunate when I met Patty,” says dean, who has been out of the hospital for 32 weeks at the time of this writ-ing. “She inspired confidence when I first met her, and I chose my hospice right then and there. She’s a sweetheart, and a professional, and she always had the right answers.”

Between 11 and 15 percent of hospice patients improve to the point that they can be discharged, or can “graduate” from hospice care. This success rate can be attributed to effective communication and collaboration among those

HOME CARE & HOSPICE

we Honor Veterans helps hospice organizations build professional and organizational capac-ity to provide quality care for veterans, develop or strengthen partnerships with Veterans Ad-ministrations and other veteran organizations, and increase access to hospice and palliative

care for veterans in the community.

“All hospices are serving veterans, but they often aren’t aware of that person’s service in the armed forces,” said J. donald schumacher, President of the National Hospice and Palliative Care Organiza-tion. “Through we Honor Veterans, we are taking a giant step forward in helping hospice and pallia-tive care professionals and volunteers understand and serve veterans at the end of life.”

Hospice of Northwest Michigan is proud to partner with the program, according to its Executive director, Amy wieland. “By recognizing the unique needs of veterans who are facing a life-limiting illness, we are able to accompany and guide these men and women through a peaceful end-of-life transition,” she says.

Tina lamont, director of Adult Health services, points out that veterans’ past military experience may be a source of angst. “For those veterans who experienced combat service or other trauma, it can be especially important to understand the kinds of past experiences that often resurface at the end of life,”

she says.

HOsPICE OF NORTHwEsT MICHIGAN Is A We Honor Veterans LEVEL II PARTNER

BEREAVEMENT ANd GRIEF SuPPORT

P22




Rev. david Behling facilitates Grief support Programs through Hospice of Northwest Michigan. These programs are avail-able in five-week sessions through the spring, summer and fall at various locations in the community. Rev. Behling

also facilitates the monthly Teen support Group and Healing with loss, a monthly support group for adults.

during 2013, Hospice of Northwest Michigan offered additional community resources for coping with grief and loss, including:

• Annual National Bereavement Teleconference, April 16, 2013: “Improving Care for Veterans Facing Illness and death”

• Annual Memorial Service, November 3, 2013

• Grief Support Workshop, November 10, 2013: “Handling the Holidays”

• Boyne City Remembrance Event, December 8, 2013: “lights of love”

P23


“you have quality nursing care, and I’ll tell anybody.”

Dean Johnston, Hospice Patient

Hospice of Northwest Michigan is a we Honor Veterans level II Partner[logo]we Honor Veterans helps hospice organizations build professional and organizational capacity to provide quality care for veterans, develop or strengthen partnerships with Veterans Administrations and other veteran organizations, and increase access to hospice and palliative care for veterans in the community.“All hospices are serving veterans, but they often aren’t aware of that person’s service in the armed forces,” said J. donald schumacher, President of the National Hospice and Palliative Care Organization. “Through we Honor Veterans, we are taking a giant step forward in helping hospice and palliative care professionals and volunteers understand and serve veterans at the end of life.” Hospice of Northwest Michigan is proud to partner with the program, according to its Executive director, Amy wieland. “By recognizing the unique needs of veterans who are facing a life-limiting illness, we are able to accompany and guide these men and women through a peaceful end-of-life transition,” she says.Tina lamont, director of Adult Health services, points out that veterans’ past military experience may be a source of . “For those veterans who experienced combat service or other trauma, it can be especially important to understand the kinds of past experiences that often resurface at the end of life,” she says.[photo: Amy wieland, Executive director, Hospice of Northwest Michigan]

HOME CARE HOSPICE BASIC CARE

involved in each patient’s care – physicians, hospice personnel, family and other care-givers, as well as the patients themselves. stabilizing patients’ medical condition and environment can, in some cases, return them to the point that they no longer qualify for – or need – hospice care.

Hospice of Northwest Michigan provides seamless transitions between home care and hospice. when a patient’s condition changes, and he or she needs to return to hospice care after being discharged, the same trusted providers can be there to provide ap-propriate care.

Always the consummate engineer, dean likes to research equipment and new ideas that can help him devise ways of managing his own quality of life – as inspired by the recommendations of his nurse, Patty. These days, dean only needs to see Patty once a month, for routine care. “You have quality nursing care, and I’ll tell any-body,” he says of Hospice of Northwest Michigan.

It takes extensive training and tremendous personal dedication to provide the kind of care needed by home care and hospice patients. In addition to being regis-tered nurses, the Health department’s home health nurses must have several years’ experience in acute care. Their clinical expertise must be accompanied by strong interpersonal and social skills – all of which are constantly put to the test, as they are called into patients’ homes during times of great discomfort and uncertainty for both the patient and family.

“Patients get specialized care from many different sources,” says donna Carlson-Alkire, Home Care and Hospice supervisor. “we’re there to look at the whole patient, the resources they have avail-able, their environment, and the different kinds of health problems they’re facing. we interact with their providers; we call pharmaceutical manufacturers; we help the patient get answers when they don’t know who to call.”

In addition to registered nurses and home health aides, the Health department’s home care staff has access to medical-social workers, pharmacists, therapists and other resources to meet the needs of the patient and family. All staff are cross-trained to provide both home care and hospice services, assuring a smooth transition for home care patients if and when hospice services are needed.

“Our staff is always available to our patients and their families,” says Tina lamont, director of Adult Health services. “They are our priority.”

Donna Carlson-AlkireHome Care & Hospice supervisor

Tina Lamontdirector of Adult Health services


EXCEPTIONALEVEN UNdER

SCHOOL- BASED SCREENINGS 13 participating schools in 2013; 2,683 children screened.

$ Provided dental services at a reduced fee to 4,362 uninsured people in Northern Michigan.

$ Provided $1,059,830 in financial assistance to 3,712 patients, of whom 1,590 were from Antrim, Charlevoix, Emmet and Otsego Counties.

NORTHERN DENTAL PLAN

P24




A SMILE Is THANKS ENOuGHIt could happen to anyone. But for Ron, the thought of having to lose all of his teeth—with no way to pay for the

urgent dental procedures he needed—was too much to bear. At 67 years of age, Ron had already experienced heart problems and had en-dured multiple joint replacements. The Cheboygan resident had run his own business for years, but when it closed, he also lost his home, and was left with only seasonal work to help him pay the bills.

After completing the initial chartings and oral exam, Tyler Allerding, dds deter-mined that Ron would need full dentures due to the severe wear and extreme deterioration of his teeth.

Removal of his teeth was also necessary to avoid complications from a dental infection. Rico Breznau, dental hygienist and office ad-ministrator for the Cheboygan clinic, recalls Ron’s devastation when he heard the news.

“After the dentist left the room, he quietly broke down in tears,” Rico said. “He was devastated to be losing his teeth, but what actually brought him to tears was the fact that he had no way to pay for the procedures he needed. He was working as a greeter, and was mortified at the thought of having no teeth while talking to customers.” Ron knew it was the only way he could remain healthy enough to work, but he had no idea how he would cover the expense.

The staff at Dental Clinics North quickly made the decision to seek financial support on Ron’s behalf through the dental Assistance Fund. during 2013, the Fund covered $1,059,830 in essential dental services to 3,712 clients, including 38 from Cheboygan County alone.

THE sTAFF AT dENTAl ClINICs NORTH IN CHEBOYGAN GO ABOVE ANd BEYONd FOR A PATIENT wHO HAd lOsT All HOPE OF AFFORdING URGENT ORAl HEAlTH CARE.

Dental Clinics North, a partnership of local health departments, is administered by the Health department of Northwest Michigan, with clinical services provided by Michigan Community dental Clinics. we provide care to patients with Medicaid, Healthy Michigan Plan, delta Healthy Kids, MIChild, Northern dental Plan, and uninsured.

TOTAL CLIENTS SERVED

23,490, including 8,911 from Antrim,

Charlevoix, Emmet and Otsego Counties.

ClIENtS SErVED alPENa 2,020CHEBoyGaN 1,695EaSt JorDaN 1,906GaylorD 3,096MaNCEloNa 2,463PEtoSKEy/HarBor SPrINGS 2,342traVErSE CIty 6,094WESt BraNCH 2,455HoSPItal ProGraM 158WiC fluoride varniSH (HdnW) 1,261

P25



“we were able to get the funding approved for Ron, along with a contribution from his church to help offset the costs,” Rico recalls. “without the entire staff working together, this would never have come together for him.” The rollout of the Healthy Michigan Plan in April 2014 makes dental services a covered benefit for eligible patients between the ages of 19 and 64. For those age 65 and over, the dental Assistance Fund will continue to provide access to needed dental care.

Ron expressed his gratitude in a letter to dr. Allerding and the staff at dental Clinics North in Cheboygan. “I cannot say enough or thank you enough for the help I have received,” he wrote.

The staff at Dental Clinics North, Cheboygan.

Ron (right) expresses his thanks to his dentist, Dr. Tyler Allerding (left).

EMMET

CHARLEVOIX

ANTRIM OTSEGO

HARBOR SPRINGS/ PETOSKEY

CHARLEVOIX

BELLAIREMANCELONA

GAYLORD

EMMEt CouNty3434 Harbor-Petoskey Rd., Suite aHarbor Springs, MI 49740

Hornet Health CenterPellston High School172 Park St.Pellston, MI 49769

CHarlEVoIX CouNty220 W. GarfieldCharlevoix, MI 49720

aNtrIM CouNty209 Portage Dr.Bellaire, MI 49615

Mancelona Familyresource Center/IronmenHealth Center205 Grove St.Mancelona, MI 49659

otSEGo CouNty95 Livingston Blvd.Gaylord, MI 49735

☎800.432.4121www.nwhealth.org

Home Care & Hospice ☎800.551.4140



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AlpenaCheboyganEast Jordan

Gaylord

DENtal ClINICS NortH ☎877.321.7070

www.dentalclinicsnorth.comHarbor Springs/Petoskey

MancelonaTraverse CityWest Branch

2013 report to the community health … 2013 report to the community...cross-jurisdictional sharing...

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