PICKAWAY COUNTY GENERAL HEALTH DISTRICT

2016 ANNUAL REPORT

Letter From the Health Commissioner:

2016 was an eventful year in public health and for our health district.

Our staff were challenged with several disease outbreak investiga-

tions including shigella, pertussis, and legionella.

We are continuing to make progress with accreditation. We are in the

process of developing the Community Health Improvement Plan

(CHIP) with help from community stakeholders. Through the accredi-

tation process, we have continued to improve upon our services pro-

vided by Vital Statistics, Clinical Health Services, Environmental Health

Services, Public Health Emergency Preparedness, and other essential

core public health services for Pickaway County.

We were fortunate to obtain two new grants through the Ohio EPA

for mosquito control and surveillance activities and household sewage

treatment system replacement projects.

I would like to thank all of Pickaway County’s support for the health

district and would like to confirm we are continually striving to im-

prove public health services for those in Pickaway County. Our ser-

vices are just a phone call, office visit, or site visit away.

Respectfully,

Vernon G. Bolender, MD

Health Commissioner

Current Board Members

Dr. Gary Gillen, President, District Advisory Council Appointment

Mike Wolford, Vice President, District Advisory Council Appointment

Craig Stevenson, District Advisory Council Appointment

Art Goodwin, District Licensing Council Appointment

Tony Mosley, City of Circleville Appointment

Jay Elsea, City of Circleville Appointment

Tami Clark, City of Circleville Appointment

Dr. Vernon G. Bolender, Health Commissioner

Contact Us

Give us a call for more information about

our services.

Pickaway County General Health District 110 Island Rd. Circleville, OH 43113

(740) 477-9667

Visit us on the web at www.pchd.org

Check out our Community

Health Assessment and Com-

munity Health Improvement

Plan online at www.pchd.org

Environmental Health Services

Data above shows a comparison of number of food opera-tions licensed in Pickaway County, number of inspections completed by PCGHD, and number of violations / critical violations documented during 2016 vs 2015. While # of inspections increased in 2016, number of violations docu-mented decreased in 2016. With an increase in number of inspections by health dept. as well as increased food safe-ty training provided by health district during 2016 could have lead to fewer critical violations and non critical viola-

2016 Environmental Health Report Obtained Ohio EPA Mosquito Control Grant to conduct seasonal mos-

quito control activities including surveillance/ trapping, larvacide appli-

cation and scrap tire abatement projects as well as providing a mosqui-

to control program internship with the health district. Over 904 scrap

tires removed from nuisance properties and 1700 scrap tires collected

during the Fall 2016 Collection Event.

Increased food safety training opportunities by holding several Level 2

Ohio Certification courses for local food service industry. A total of 64

food service managers successful passed the certification program in

Pickaway County in 2016.

Obtained Water Pollution Control Loan Funds from Ohio EPA for eligi-

ble homeowners to fund repair and replacement of sewage treatment

systems and began sewage system replacement projects in October of

2016.

Conducted investigations,/ inspections of food operations, pools,

schools, campgrounds, private water systems, solid waste and com-

posting operations, & sewage systems. Completed nuisance and

rabies investigations.

Current Staff: Kelly Dennis, Environmental Health Director

Candy Schwalbauch, Clerk

Emily Dieterich, Sanitarian-in-training

Jenifer Hassinger, Registered Sanitarian

2016 EH Program data Inspec-tions

Additional activi-ties

Food 830 1288

Sewage 862 1977

Water 219 477

Pools 71 122

Camps 29 92

Nuisances 402 369

Solid Waste Program 57 83

Animal Bites / Rabies 116 140

Mosquito Control 241 347

School Inspections 46 81

Other Inspections 33 114

Totals for 2016 2906 5090

385

686

320

636

956

382

830

332

496

826

Food Protection Program Data

2015 2016

Data above reflects on comparison of number of animal bite investigation

by species. We were fortunate to have 0 zero animals test positive for

rabies during 2016.

Data above shows number of inspections vs. activities per-

formed by Environmental Health Sanitarians during 2016.

Inspection totals include standard inspections and follow-up

inspections. Activities include emails, phone calls, letters,

reports, meetings, and other activities with each program.

Environmental

Health Services

Provided

Food Operation Li-

censing, inspection,

consultation, and train-

ing programs

Well permitting and

water sampling

Sewage system per-

mitting, inspection ser-

vices, real estate eval-

uations.

Swimming pool licens-

ing inspection and

consultation.

Campground licensing,

inspection, and consul-

tation

School Environmental

Health Inspections

Animal Bite Investiga-

tion and Rabies testing

Nuisance complaint

investigation and en-

forcement

Solid Waste and Com-

post Facility Inspection

and licensing

Scrap Tire Generator

Inspection and En-

forcement

Disease Outbreak In-

vestigation

Tattoo and Body Art

Facility Permitting and

Inspection

Vector Control and

Mosquito Surveillance

and Prevention

Visit our website at

http://www.pchd.org/

environmental.html to

2016 Mosquito Control Grant PCGHD Scrap Tire Clean Up Projects # of Tires Re-

moved

Five Points Pike Scrap Tire Open Dump (Monroe TWP) 495

Logan Street Alley (Circleville) 25

Heffner Road Scrap Tire Nuisance (Saltcreek TWP) 304

Hayesville Road Scrap Tire Nuisance (Pickaway TWP) 80 PCGHD, RPHF Solid Waste District, Pickaway Commissioners Tire Collec-tion Event Fall 2016 1700

Total 2604

Public Health

Nuisance investi-

gation data (left)

demonstrates

number of com-

plaints investigat-

ed in 2015 com-

pared to 2016.

We observed an

increase in com-

plaints reported in

2016.

Environmental Health Services

Mosquito Surveillance Traps set up at a location

outside of New Holland, Perry TWP

2016 Mosquito Surveillance Data

Total Number of Mosquitos Trapped and tested 1455

Total Number tested positive for West Nile Virus 3 pools (pools consists

Percentage Tested Positive For West Nile Virus < 10.3 %

Data below indicate number of scrap tires

removed from nuisance properties and

collections events utilizing Mosquito Con-

trol Program funds during 2016. By re-

moving scrap tires from communities, we

can help reduce mosquito harborage con-

ditions which can help reduce risks of

mosquito borne illness such a s West Nile

Virus and encephalitis.

Data above indicates evidence of West Nile virus in the mosquito population from mosquitos trapped

and tested from Pickaway County during 2016. West Nile Virus (WNV) can be spread through the

bite of an infected mosquito and can cause illness in humans and animals. When evidence of WNV

is discovered in mosquito populations, health district staff will increase awareness within areas evi-

dent of WNV as well as try and coordinate removal of nuisance conditions that can harbor mosquitos

or mosquito breeding (i.e. tall grass and weeds, stagnant water, scrap tires)

CLINICAL SERVICES

AVAILABLE TO PICK-

AWAY COUNTY RES-

IDENTS IN 2016

Tuberculosis Screen-

ings and Clinics

Free HIV Testing and

Education

Pregnancy Testing

Immunizations

Health Education

Free Vision Vouchers

for Children

Hemoglobin Screen-

ings

Communicable Dis-

ease Reporting and

Tracking

Head Lice Checks

SIDS Follow-up

Newborn Screenings

Blood Pressure

Checks

Lead Tests/Lead In-

vestigations in Homes

Emergency Prepared-

ness

Child Fatality Review

BCMH Program

Home Visits

Foster Family Nursing

Assessments

2016 Clinical Health Services Report The Clinical Health Services Department at Pickaway County General Health District is dedicated to

protecting and improving the health of the residents of our community. Our goal continues to be the

evaluation and promotion of services to meet the ever-changing health care needs of the residents of

Pickaway County.

Immunizations are provided through the Vaccine For Children Program sponsored by the Ohio Depart-

ment of Health. These vaccines are provided at no cost to eligible children through 18 years of age

that are Medicaid eligible, uninsured, under-insured, American Indian, or Alaskan Natives. Our agen-

cy must screen these children appropriately for eligibility.

Our BCMH program is going full force again. Our nurse provides needed assistance through home

visits and case management for children with special health needs in the community. There are cur-

rently 109 children on this program in Pickaway county. This program provides billable revenue of our

department.

Our department participated in numerous activities though out the year in our community including the

Community Baby Shower, Westfall Mall Day, Pickaway County Fair, Kids Day at the YMCA, Kinder-

garten Registration at Laurelville Elementary, Westfall POD set up, and a functional Exercise at the

Pickaway County General Health District.

The Director of Clinical Services routinely attends various agency meetings including, but not limited

to, Family and Children First Council, Local Emergency Preparedness, Health Care Coalition, and the

Continuum of Care Meeting. Our agency collaborates well with other local agencies to ensure that

accurate resource material is available and services are not being repeated.

Much of this year has been spent preparing for the Accreditation process. We have been assigned

Domains, that we are responsible for finding and maintaining the proper documentation. We have

participated in meetings for the CHIP (Community Health Improvement Plan) and for the QIA( Quality

Improvement and Assessment) process.

We have had several outbreak investigations that occurred during 2016, among which were, a Shigel-

la Outbreak, a Pertussis outbreak, and a Legionella Outbreak. It requires a great deal of time to track

and document these outbreaks. We continued to track our routine diseases as well. There are over

110 mandated infectious diseases that must be reported to our local health departments. These in-

clude tuberculosis, meningitis, Hepatitis C, pertussis, sexually transmitted diseases, influenza, and

food-borne illnesses. Nurses enter information into ODRS(the database), make home visits, interview

clients, and provide educational counseling to those with reportable diseases.

Our ongoing goal is to provide the highest quality of services to the Pickaway County residents in an

efficient and timely manner.

Clinical Health Services

Current Employees: Elaine Miller, RN,BSN, Clinical Health Director Sabrina Alphin, Clerk Barbara Steward, Public Health Nurse Karen Geider, BCMH Nurse Mindy Shears, Emergency Preparedness Coordina-tor

Clinical Health Services

Communicable Disease Report 2015 2016

Brucellosis < 5 0

Campylobacteriosis < 5 10

Chancroid 0 < 5

Chlamydia 142 172

Cryptosporidiosis < 5 10

E. coli < 5 < 5

Giardiasis < 5 < 5

Gonorrhea 16 24

Haemophilus influenzae < 5 < 5

Hepatitis A 0 5

Hepatits B 34 59

Hepatits C 140 215

Legionnaires' disease < 5 5

Lyme disease 0 < 5

Meningitis Bacterial < 5 < 5

Mumps < 5 0

Mycobacterial Non-TB 5 < 5

Pertussis 8 43

Salmonellosis 7 9

Shigellosis 0 14

Steptococcal disease, Group A < 5 < 5

Streptococcal disease Group B < 5 < 5

Streptococcus Pneumoniae < 5 8

Varicella 7 < 5

Zika 0 < 5

Total 392 596

Influenza

Influenza-associated hospitalization 34 13

Influenza Suspected 221 229

Influenza Confirmed 141 139

Influenza Confirmed Type A 50 33

Influenza Confirmed Type B 53 < 5

Total Influenza Cases 362 368

TB Tests Given 279 230

Correctional Facility Communicable Disease Reports 2015 2016

Chlamydia 26 31

Coccidioidomycosis < 5 0

Giardiasis <5 0

Gonorrhea 9 15

Hepatitis B 37 60

Hepatitis C 1299 1950

Hepatitis E 0 < 5

Influenza-associated hospitalizaion 0 4

Legionnaires' disease 0 < 5

Mycobacterial Non-TB < 5 < 5

Salmonellosis < 5 0

Total Correctional Facility Communicable Diseases 1376 2063

Data above indicates number of communicable diseases investigated by dis-

ease type and does not indicate total number of diseases confirmed and shows

trends from 2015 to 2016.

0 38

14

5

43

SHIGELLOSIS LEGIONELLA PERTUSSIS

2016 Disease Outbreak Investigation Data

2015 2016

2016 Disease Outbreak Response Activities:

Due to the increase number of suspected cases of shigello-

sis, pertussis, and legionella, our agency increased public

awareness and disease prevention outreach within the com-

munity to help reduce public health risks associated with

such diseases. Outreach activities for pertussis prevention

included collaboration with school nurses and medical pro-

fessionals to help inform and educate community about pre-

vention measures for pertussis which include immunization.

Some of our outreach activities due to the increased number

of suspected cases of shigella included making public health

advisory announcements for safe recreational water activi-

ties, educating local schools about prevention measures for

shigella including frequent handwashing for both staff and

students, and protecting food from contamination from in-

fected food handlers.

As for our legionella investigations, we increased awareness

for patient care facilities about potential sources or harbor-

age conditions for legionella, which included recommenda-

tions for facility inspections, monitoring and maintaining

proper water temperatures in plumbing systems, ensuring

facilities have adequate ventilation systems, and testing high

risk populations for legionella.

What is Public Health Department Accreditation? • The measurement of health department performance against a set of nationally recognized, practice-focused and evidenced-based standards. • The issuance of recognition of achievement of accreditation within a specified time frame by a nationally recognized entity. • The continual development, revision, and distribution of public health standards. The goal of Ohio’s mandated national accreditation requirement is to improve and protect the health of the public by advancing the quality and performance of local health departments.

A Message from Sharon Stanley, Accreditation Coordinator Pickaway County General Health District Pickaway County General Health District (PCGHD) is now in its second year of accreditation preparation. We started in 2015 with a Com-munity Health Assessment, one part of almost a 100 requirements in 12 separate performance areas that will need to be uploaded for the National Public Health Accreditation Board (PHAB) review. PCGHD is carefully following its timeline for the review and visit progress. The PHAB Site Visitors will come to Pickaway County from the Washington D.C. area in the spring of 2018. The health department continues to meet its monthly self-planned timelines in terms of its accreditation process and has completed most all of six of the twelve Domain requirements at the end of 2016. We also formally registered with PHAB and received an approval for our application. In 2017, we will launch the other six areas of Domain work and pull it all together for a final look just prior to our submission of documents in late fall. Although the requirements for the initial review are documents, the real purpose of accreditation is to make sure that our operations and activity is reflecting what we say we do on paper. The good news is that PCGHD doesn’t have to do everything that the accreditation requires by itself, a relief given our 12-employee agency and the operational restraints within our current budget. We do have to lead the effort, though, and our staff is staying extra busy these days. PCGHD must make sure that residents in our communi-ty are receiving essential and core services of public health to: 1) Prevent epidemics and spread of disease 2)Protect against environmental hazards 3) Prevent injuries 4) Promote and encourage healthy behaviors 5) Respond to disasters and assist communities in recovery 6) Assure the quality and accessibility of services. The health department is engaging the help of longtime partners and supporters to make sure that we have the policy and operations in place across our county to protect the public’s health. You may have heard that we are now working on a Community Health Improve-ment Plan (a CHIP) after finishing our Community Health Assessment. This plan will be released in August of 2017 and involves over 40 partner agencies and members of the public. If you might be interested in joining our effort to assure “A HEALTHY COMMUNITY” it’s not too late! Please call Sharon at 740.477.9667 Ext. 139.

Accreditation

In Ohio, 15 out of 120 local health departments are already accredited. The mandate for LHD accreditation is to accomplish this

process by 2020. Ohio is the only state that mandates what was designed as a voluntary process by the Public Health Accredita-

tion Board. Screenshot credited to PHAB, 2017, retrieved from http://www.phaboard.org/

Vital Statistics and Administration

Current Vital Statistics / Administration Employee Paula Johnston (Deputy Registrar and Accounts Clerk) manages the vital statistics office for Pickaway County as wells as all accounts for the health dis-trict. Vital Statistics office is where you obtain birth and death rec-ords/ certificates in Pickaway County.

Vital Statistics Services Provided: Birth Certificates Death Certificates Burial Permits Files medical supplements Files Certificates of Service Issues Birth Correction Affidavits Executes Birth Correction Affidavits Processes Birth / Death Verifications Processes Paternity Affidavits Issues Government Use Only Copies Assists in Genealogy Research

Certified copies of birth and death certificates are $28.00 in Pickaway County. Of the $28.00 fee, $1.45 goes to Domestic Violence Prevention Fund, $1.00 goes to the Local Subsidy Fee, $2.91 to the Ohio Chil-dren Trust Fund, $3.00 Vital Statistics Base Fee to Ohio Department of Health, $5.00 to Vital Statistics Technology Fee to Ohio Department of Health, and $14.64 remains locally in our Vital Statistics fund to help cover costs of administering the program.

2016 Vital Statistics Number

Births Registered 377

Births Verified 15

Birth Certificates Issued 321

Birth Affidavits Processed 14

Paternity Affidavits Processed 1

Deaths Registered 373

Burial Permits Issued 316

Fetal Deaths Registered 4

Deaths Verified 16

Death Certificates Issued 1382

Death Affidavits Filed 14

Certifcates of Service Filed (Death) 4

Clinical Services—BCMH Bureau for Children with Medical Handicaps (BCMH)

# of children active in BCMH diagnostic, treatment, etc 219

# of children contacted (unduplicated by phone or visits) 135

# of children with primary care physician or medical home identified 89

# of children with Primary dentist identified 73

Number of Children that have:

a. Individualized Education Plan (IEP) 34

b. Individualized Service Plan (ISP) 7

c. Individualized Habilitation Plan (IHP) 0

d. 504 Plan 6

e. Comprehensive Service Plan (CSP) < 5

f. Individual Family Service Plan 7

Barriers to care for all children served

Family Health issues <5

Lack of BCMH providers <5

No Transportation 7

Nutritional Issues <5

Family Dynamics <5

82, 6%

1250, 94%

BCMH Program Activities

BCMH Stats

# of Site Visits

# of activities conducted in program

Data to the left shows BCMH program statistic for

clients within Pickaway County for 2016. Data above

shows activity summary of our BCMH nurse for 2016

including site visits vs. number of program activities.

Current Fiscal Officer: Steve Hawkins

2016 Fiscal Report

PERSONNEL ADVANCES AND

TRANSFERS

CONTRACTS

TRAVEL

SUPPLIES/EQUIP.

REMIT TO STATE MOSQUITO

CONTROLOTHER CHARGES

2016 Expense Report