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Report to the Board of Health – March-April 2019
DeKalb County Health Department Leadership Team • Lisa Gonzalez, MPH - Public Health Administrator • Brenda Courtney - Director of Administrative Services • Cindy Graves, RN, MSHA - Director of Community Health &
Prevention, Health Promotion & Emergency Preparedness • Greg Maurice, LEHP – Director of Health Protection
MONITOR HEALTH Vector Control The Animal Control wardens work in conjunction with the Communicable Disease staff when a bat is removed from a residence where potential rabies exposure may have occurred.
Vector Control March 2019
April 2019
2019 YTD
2018 Total
Bats Removed 2 1 3 49 Positive Bats - - - 2 Mosquitos Tested - - - 67 Positive Mosquitos - - - 22
Vital Records
Vital Records March 2019
April 2019
2019 YTD
2018 Total
Death Certificates Filed Medical Certificate of Death 48 55 205 694 Coroner’s Temporary Certificate 5 4 22 45 Coroner’s Permanent Certificate 7 6 30 88 Fetal Death Certificate 1 - 2 6 Birth Certificates Filed Birth Certificates 73 78 287 1,022
Board of Health Report March-April 2019 - Page 2 of 12
DIAGNOSE AND INVESTIGATE Communicable Disease (CD)
• CD investigated an outbreak of influenza in a long-term care facility. Provided education on disease containment and surveillance and facilitated daily reporting with the facility. Collaborated with Infection Control Practitioner at local hospital for enhanced surveillance in the emergency department.
HIV Case Management
HIV Case Management (Monthly Average)
March 2019
April 2019
2019 YTD
2018 Total
Clients Enrolled (Monthly Average) 44 43 44 43
Communicable Diseases March 2019
April 2019
2019 YTD
2018 Total
AIDS - - - 1 Arboviruses (including WNV) - - - 1 Campylobacter 1 2 4 18 Chickenpox - - 2 3 Chlamydia 53 53 180 520 Cryptosporidiosis 1 1 2 1 Cyclosporiasis - - - 1 Enteric E-Coli - - - 4 Gonorrhea 9 15 44 133 Haemophilus Influenza - - - 6 Hepatitis B - 1 1 6 Hepatitis C - 1 4 32 HIV - - - 2 Influenza (with ICU Hospitalization) 6 1 12 26 Legionnaires Disease - 1 1 1 Lyme Disease - - - 3 Measles 1 - 2 - Mumps - - 1 - Pertussis - - - 3 Rabies Potential Exposure - - 4 27 Salmonellosis (Non-Typhoid) 1 - 2 11 Staphylococcus Aureus Infections with Intermediate or High Level of Vancomycin Resistance
- - 1 -
Streptococcal Group A Invasive - - 1 3 Syphilis - - 2 2 Trichinosis - - - 1 Unusual Illness - - - 1 Total Reportable Diseases 72 75 264 806 Total Case Investigations 97 98 335 1,062 Total Outbreaks 1 1 3 7
Board of Health Report March-April 2019 - Page 3 of 12 Food Complaints Staff investigate complaints of food establishments when someone becomes sick after eating, or finds an unacceptable issue with the establishment.
Food Complaints March 2019
April 2019
2019 YTD
2018 Total
Foodborne Illness Complaints - 1 1 13 Confirmed FBI Complaints - - - - Non-foodborne Illness Complaints 5 4 9 13
Nuisance Complaints Staff investigates public health nuisances in unincorporated areas of the County. Staff also refer the public to municipal contacts when the nuisance is located in a municipality.
CD Partner Treatment Program The Communicable Disease (CD) staff continues their efforts in identifying and preventing further spread of Sexually Transmitted Infections (STI) in the County. Those who are diagnosed by a community partner (clinic, emergency department, private physician) are notified through the state reporting system, INEDSS and are contacted by the CD staff who are able to identify contacts (i.e. partners) about an STI and work with them to receive treatment and STI prevention messages.
Partners Treated for March 2019
April 2019
2019 YTD
2018 Total
Chlamydia 2 3 9 40 Gonorrhea - - 1 9 Syphilis - - - 2
Septic Complaints Staff investigate complaints of septic failures.
• Staff have confirmed that the 4 residences on Greenwood Acres Drive in DeKalb with illegal septic systems have disconnected from the tile. A contractor was able to verify that a 5th residence had an onsite system. We are now waiting on permit applications to be submitted for new septic systems.
Nuisance Complaints March 2019
April 2019
2019 YTD
2018 Total
Nuisance Complaints - 1 11 19 Nuisance Referrals 4 5 12 39
Septic Complaints March 2019
April 2019
2019 YTD
2018 Total
Septic Complaints - 1 3 3
Board of Health Report March-April 2019 - Page 4 of 12 Tuberculosis Program
Tuberculosis March 2019
April 2019
2019 YTD
2018 Total
Tuberculin Skin Tests Administered and Interpreted 67 48 262 1214
Clients being Case Managed Receiving Preventative Tuberculosis Therapy 1 2 4 26
Clients being Case Managed and Receiving Therapy for Active Disease - 2 2 7
Home or Directly Observed Treatment Visits 4 7 12 12
INFORM, EDUCATE, AND EMPOWER
Website and Social Media Contacts for March through April 2019
Website & Social Media Analytics March 2019 April 2019
2018 DCHD Users 1,935 2,639 - DCHD Session 2,729 3,380 - DCHD Bounce Rate (average) 1.94% 3.28% - Facebook Likes 974 1,155 903 Twitter Followers 238 242 232 Instagram Followers 260 266 246
Topic Specific Press Release and/or Website Updates
• During this reporting period, the Department released three (3) press releases: o Annual Report Released, April 5, 2019 o Household Electronics Collection, April 17, 2019 o Upsurge in Measles Cases, April 18, 2019
Media Interviews
• During this reporting period, the Department participated in four (4) media interviews: o March 1, 2019 – Mrs. Gonzalez participated in a telephone interview with WNIJ about Measles
Prevention. o April 16, 2019 – Mrs. Gonzalez participated in an interview with the Daily Chronicle on the
2018 DCHD Annual Report. An article was published on April 26th and is included in News and Correspondence of the Board of Health packet. Article is also available at: https://www.daily-chronicle.com/2019/04/26/report-informs-dchds-health-focus/agnrwgq/
o April 18, 2019 – Ms. Graves and Mrs. Schmidt participated in an interview with the Daily Chronicle on Measles. An article was published on April 19th and is included in News and Correspondence of the Board of Health packet. Article is also available at: https://www.daily-chronicle.com/2019/04/18/dekalb-county-health-department-provides-update-on-local-measles-cases/aa2btad/
o April 25, 2019 – Mrs. Gonzalez participated in a telephone interview with WNIJ related to Tobacco 21.
Illinois Tobacco-Free Communities (ITFC) Grant • The SFY2019 Illinois Tobacco-Free Communities regional grant agreement, was amended to increase
the award from $200,000 to $290,029.25. As mentioned in the last report, this amendment includes $70,000 in federal funds and $20,029.25 in state funds. The additional dollars will cover a missed
Board of Health Report March-April 2019 - Page 5 of 12
payment for January – June 2018 and also allow us to implement an additional CDC TIPS Media Campaign this Spring.
• Launched the Regional E-cigarette prevention campaign. Collaborated with region and media partners to coordinate campaign in theater, Comcast ads, social media, and Shaw Media.
• Initiated the Standardized Tobacco Assessment for Retail Settings (STARS) to characterize the availability, placement, promotion, and price of tobacco products.
• Health Promotion Specialist attended the Statewide Tobacco Training on March 26-27 in Springfield. MOBILIZE COMMUNITY PARTNERSHIPS Community Collaboration
• Ms. Graves continues to attend the University Village (UV) Collaboration meetings with a chance to interact with the residents while they are there for the Grow Mobile food distribution.
• Staff participated in the UV Resource Fair. Staff interacted with the kids using My Plate resources.
• Staff participated in the YMCA Healthy Kids Day on March 26th, the Community Expo on March 28th, NIU Wellness Fair on April 3rd, and DeKalb Wellness Fair April 25th.
• Mrs. Kendrick participated in the CATCH program on March 6th and April 3rd in Sycamore schools.
• Mrs. Gonzalez provided a presentation at NIU School of Public Health on Health Department Services and the Community Health Needs Assessment.
• Mrs. Gonzalez prepared a voice-over presentation for the online NIU MPH Program on Health Disparities and the Community Health Needs Assessment.
• Mrs. Schmidt presented on communicable disease investigations and practices to the NIU Epidemiology class
• Ms. Chase coordinated with NIU to provide 4 Dietitian graduates internships in WIC. • Ms. Graves presented two 2.5 lectures on Public Health to the Population Focused Health Nursing classes.
Emergency Preparedness (EP)
• DCHD EP presented the Rockford Region Point of Dispensing (POD) training on April 9th. Focus of the training was to give the participants tools to go back and train their staff on the POD principles.
• IDPH State site visit for EP was conducted on April 9th. Positive feedback was received. Solid Waste and Recycling The Solid Waste and Recycling Program strives to reduce waste generated in our county. We do this through a variety of means which include special waste collections, advertising and educational campaigns, in addition to community interactions.
• Events currently scheduled for 2019: o Electronic collection will be held on May 4th. During the event, over 300 cars were served, filling
3 semi-trailers with electronic waste. o Household Hazardous Waste collection will be held on June 8th. o Electronic collection will be held on September 7th.
Solid Waste Program March 2019
April 2019
2019 YTD
2018 Total
Community Contacts 43 48 153 659 Community Outreach - - - 48 Partnership Outreach 1 3 23 68
Board of Health Report March-April 2019 - Page 6 of 12
POLICIES AND PLANS IPLAN – Community Health Needs Assessment Priority Highlight: Behavioral Health
• Initiative – Trauma Informed System of Care o Ms. Graves and Mrs. Gonzalez have been working closely with Jennifer Junck, PNP, Doctoral
Candidate at Rush University. The initial staff training on Trauma is set for June 24, 2019. Prior to that date, we will initiate two assessments to obtain baseline data from staff. The data from the assessments will also be used to tailor the training to meet the needs of our workforce.
o Following the all-staff training, we will establish a Trauma Informed Care Advisory Committee which will provide recommendations for follow-up training opportunities for staff and Trauma Informed Policies and Procedures.
Priority Highlight: Maternal and Child Health • Initiative – Basics DeKalb County
o Mrs. Gonzalez worked as part of an interdisciplinary recruitment team to interview and hire the Coordinator for the Basics DeKalb County Initiative. The Coordinator has spent her first month meeting with various community partners to begin discussions on how partners can educate the families they serve about the Basics.
o The Health Department will be working in the coming months to develop a plan to incorporate the Basic messaging into their interactions with young families.
o For more information on the Basics, please visit: www.basicsdekalbcounty.org
Policy Development • Senior Leadership staff continued work on two new policies, a social media use policy and a recruitment
policy. Once drafted, both policies will be reviewed by the Labor Attorney and Collective Bargaining Unit and then brought to the full Board of Health for approval.
ENFORCE LAWS Animal Control
• Animal Control staff took possession of a dog at the end of March for the City of DeKalb, who charged a resident with animal cruelty. Animal Control was asked to review a video of the incident by the States Attorney, to provide support for additional charges. The dog is still being held by Animal Control pending the court case because the resident has been unwilling to relinquish ownership. The next court date is in June.
Animal Control Program March 2019
April 2019
2019 YTD
Total 2018
Dogs Registered for One Year 549 475 1,841 5,623 Dogs Registered for Three Years 475 268 1.159 3,116 Animals Impounded 4 9 42 122 Wildlife Handled 4 6 14 90 Specimens Examined for Rabies 3 2 7 67 Specimens Positive for Rabies - - - 1 Animal Bites Reported and Investigated 21 17 71 177 Rabies Reminder/Late Notices 340 - 407 3,820 Livestock Kills Investigated - - - -
Board of Health Report March-April 2019 - Page 7 of 12 Environmental Health
• Food staff continue to educate establishments of new requirements, layout of inspection forms, and the fact that inspections are no longer scored. Inspections are taking about 25-30% longer to complete now.
Environmental Health March 2019
April 2019
2019 YTD
2018 Total
Food Food Establishments 554 555 554 554 Routine Food Inspections 48 65 149 768 Follow-up Inspections 10 6 23 126 Plan Reviews Conducted 2 2 8 16 Pre-operational Inspections 1 - 13 22 Temporary Inspections 13 3 22 372 Other Food Inspections 1 3 5 58 Trainings Conducted for the Public - - - 1 Private Sewage Sewage Permits Issued 4 1 8 23 Inspections Conducted - 1 2 24 Consultations 3 5 14 12 Presentations to the Public - - - - Private Water Water Well Permits Issued 5 1 10 41 Comprehensive Inspections - 3 5 4 Water Samples – New & Existing 10 18 33 49 Water Wells Sealed/Abandoned - 3 3 23 Consultations - - - 8 Presentations to the Public - - - - Non-Community Well New Sites Inspected 3 - 3 - Water Samples - 3 3 12 Biennial Surveys Completed - 3 3 12 Site Verifications Site Verifications 6 12 26 62 Real Estate Inspections Real Estate Inspections Well/Septic 2 4 7 56 Real Estate Inspections Well Only 2 4 8 11 Real Estate Inspections Septic Only - - 1 5 Tanning Inspections - 1 2 9 Body Art Inspections - 1 2 6
Smoke-Free Illinois Act – Tobacco Compliance Checks Staff perform site visits to investigate the validity of complaints. Also, during routine food inspections, inspectors verify compliance with the Act.
Smoke-Free Illinois Act March 2019
April 2019
2019 YTD
Total 2018
Complaints - - - 5 Site Visits for Compliance 48 65 149 768
Board of Health Report March-April 2019 - Page 8 of 12
LINK TO/PROVIDE CARE Community Lab Draw Program
• Ms. Graves has continued to put together the Community Lab Draw Program (CLD). Ms. Graves had a meeting with Dr. Thornton to work through the steps to address the Provider’s needs.
• Other communities have found that it is a highly valuable service to those who are uninsured or underinsured.
• All nurses will be trained in phlebotomy to perform venous draws for the Community Lab Draw pilot program. Training will take place on Wednesday and Thursday, May 29 & 30th and staff will attend one of four sessions (am or pm). Training will be completed by Jeanne Isabel (our lab director) and our representative from the UIC Health Lab who will be our reference lab. The clerical tasks will be kept with clerical staff—i.e. putting in the lab orders, payments and readying for courier.
• The CLD pilot program will service clients on Monday and Friday by appointment only. The program will be primarily based through the Family Planning Program, but all will need to support the program. We are anticipating a start date of July 1st.
• The client is responsible for providing a written prescription from their healthcare provider detailing the specific blood specimen to be drawn and submitted. The prescription will be kept on file at DCHD. Two exceptions to providing a written prescription will be covered as a standing order from Dr. Thornton as our Medical Director:
o Those clients who are presenting for school- or work-required antibody titers (Hepatitis B, Measles, Mumps, Rubella, Varicella) may have these drawn and submitted with proof of school or work requirement.
o DeKalb County employees who participate in the yearly Wellness Screening may have a Lipid Profile and Hemoglobin A1C drawn at the screening event.
• The client will sign a consent that addresses the following: o Permission for DCHD to obtain a blood specimen(s) via venipuncture. o The client has provided the DCHD with a written prescription of the lab tests to be drawn with the
name, fax number, and office phone number of their primary care provider and they understand and consent that the results of the tests will be faxed to that office.
o The client consents that they understand and acknowledge that the DCHD is NOT their primary care provider and that it is the client’s responsibility to follow up and to be pro-active in their health care.
o The client’s provider will be responsible for follow-up on abnormal lab results. UIC lab will assume the responsibility of notifying the physician/answering service for any panic level results.
o The client understands that the DCHD is only providing a cost-effective service today and DCHD, its Medical Director, nor the staff are held liable for any test results.
o The client understands that this is a cost-effective program and DCHD will not bill or assist in billing of any health insurance plan; the client further agrees that they will not submit the receipt to their insurance company.
Drug Screening We serve Kishwaukee College Nursing, Nursing Assistant, Radiology, Lab Technician, Massage Therapy, EMT, Pharmacy Tech, Dental Assistance, Sterile Processing, Veterinary Assistant and Paramedic programs.
Drug screening stats March 2019
April 2019
2019 YTD
Total 2018
Number screened 22 12 63 314 Number sent for follow-up clearance -- -- -- 10
Board of Health Report March-April 2019 - Page 9 of 12 Family Case Management (FCM)
• FCM/Healthworks (DCFS), and High Risk Follow up yearly state audit completed. • Received notification of the assigned caseloads for SFY20. FCM assigned/projected caseload is 620
(an increase of 30 cases) at a reimbursement of $468/case and the high-risk infant/Healthworks (DCFS) caseload remained at 130 at a reimbursement of $600/case.
o Concern with SFY20 home visiting requirements: FCM - a minimum of 1 home visit required for all pregnant women and all infants with
no differentiation between Not-at-Risk vs At-Risk clients. In 2018, we had 600 total intakes that would fit this description with two home visits
required per case (once during pregnancy and once for the infant) = average of 4.6 visits per worked day.
High-risk infant and Healthworks—expected at age 3-4 months with a focus on sleep and SIDS reduction. In 2018, we had 60 total intakes that would fit this description = average of 1.2 visits per week.
Total home visits that are required within our case load in 2018 were 75. This is 1,185 visits less than what will be required in FY20.
Family Case Management March 2019
April 2019
2019 YTD
Total 2018
Individuals Served 668 700 2,680 8,347 Intakes (pregnant, infants, DCFS, and APORS) 63 58 226 660
Active DCFS Clients (monthly average) 61 63 62 60
Active APORS Clients (monthly average) 35 35 37 59
Office Visits 333 358 1,331 3,762
Home Visits 7 4 23 75 Family Planning
• Gap Funding Proposal approved and implementation begun: o Bus Shelter Campaign o HIV testing offered for those unable to pay o HPV vaccine offered for those unable to pay o Outstanding LARC reimbursement o Colposcopy and Biopsy
Family Planning Program March 2019
April 2019
2019 YTD
Total 2018
Comprehensive Exams 73 67 268 698 Other Medical Visits 116 127 433 1,254 Pregnancy Tests 52 48 167 440 STD Tests Performed 236 227 900 2,394 STD Treatments* 40 42 165 411 Total Visits 189 194 712 2,045
*Those clients who are diagnosed and treated through the Family Planning services or through the STI Clinic are also encouraged to have their partners notified and treated through these programs.
Board of Health Report March-April 2019 - Page 10 of 12 Healthcare Enrollment Application Program (HEAP)
Healthcare Enrollment March 2019
April 2019
2019 YTD
Total 2018
Appointments 20 21 67 310 Marketplace Applications Completed 8 2 15 128 Medicaid Enrollments 18 27 66 233 New Clients Served 20 21 63 306
Immunizations
Vaccinations March 2019
April 2019
2019 YTD
Total 2018
VFC Children Immunized 214 213 803 3,086 VFC Immunizations Given 615 594 2,202 8,166 CHIP Children Immunized 13 19 51 298 CHIP Immunizations Given 31 37 104 551 Private Pay Children Immunized 9 9 46 249 Private Pay Immunizations Given 16 10 71 410 Adult Clients 46 46 211 2,088 Adult Immunizations Given 66 61 286 2,291
Lead Testing
Medical Cannabis Pilot Program (MCPP) Application Assistance
Lead Testing March 2019
April 2019
2019 YTD
Total 2018
Children Screened by Health Department 1 2 4 17 Number of County Children Being Followed for Elevated Lead Levels (monthly average)
11 11 8 6
Home visits completed 1 - 2 7
Medical Cannabis March 2019
April 2019
2019 YTD
Total 2018
(6 months) Clients assisted 24 28 101 103
Board of Health Report March-April 2019 - Page 11 of 12 Vision & Hearing Program
• Received word that DeKalb Schools (District 428) would like to resume our arrangement of contracting for their schools’ Vision & Hearing requirements beginning in the 2019/2020 school year. MOU has been signed and received.
Screenings Completed March 2019
April 2019
2019 YTD
Total 2018
Grant Vision Screening/ Rescreening 132 130 542 1,926
Grant Hearing Screening/ Rescreening 136 139 570 2,052 Contracted Vision Screening/ Rescreening 40 95 380 1,859
Contracted Hearing Screening/ Rescreening 41 149 525 2,705
Women/ Infants/ Children (WIC)
WIC Nutrition Program March 2019
April 2019
2019 YTD
Total 2018
Individuals Certified 198 188 731 2,270 Individuals Picking up Coupons 1384 1386 5,375 16,786 Caseload Percentage 82.8% 82.9% 80.4% 81.28%
ASSURE COMPETENT WORKFORCE Staff Training and Development
• DeKalb County Health Department hosted a Special Processes at Retail training for regional LHD Food Program staff on April 23 and 24, 2019. All Health Protection staff participated.
• Accounting staff attended an Excel seminar in order to improve skills, and to better understand the concept of ledgers.
Staffing Trends: November/December
Total Employees Full-Time Employees
Permanent Part-Time Employees New Hires Separated
Employees 42 37 5 0 1
EVALUATE: ADMINISTRATION, MANAGEMENT AND GOVERNANCE Quality Improvement
• The Illinois Department of Human Services, Division of Family and Community Services conducted an On-Site Fiscal Contract Compliance Review on April 25, 2018. We received formal notification that we met contract requirements and no findings were identified.
Board of Health Report March-April 2019 - Page 12 of 12 Billing Updates
• Since the go-live date in February 2018, CDP has continued to provide technical support and training through webinars, email and phone consultation as needed.
Billing Claims Processed March/April 2019 Private Insurance and Medicaid 1,437 County and State Employee Flu 25
Total 1,462
• Mrs. Courtney and Accounting staff continue to work closely with CDP on a daily basis. We work as a team on the monthly CDP Statement Lists which indicates why claims were denied and which clients should be billed for balances due.
Fiscal Updates • We have begun to receive information from our State funders regarding SFY2020 grant funding and
application requirements. All pre-grant requirements for SFY2020 have been completed. The program budget and Uniform Grant Agreement has been completed for the SFY2020 WIC grant.
• Administration staff continued to work towards the close out the 2018 financial reports. This year, there have been several changes/delays in grant payments and the audit has experienced various delays at the County-level as well, therefore the presentation of the 2018 Audited Financial Statement will be moved to the July meeting agenda.
• Federal Match for Family Case Management (FCM) o As reported at the March 2019 meeting, IDHS has been working to determine the future
sustainability of the Family Case Management Federal Match. The issue that exists is that the claimable costs for providing services have been impacted by the introduction of case management provided by Medicaid Managed Care (MCO). Shortly after the beginning of SFY2019, it was discovered that the Claim Reports generated at the IDHS, were not consistent with the data that IDHFS had within their system.
o We have heard from IDHS that they have identified a temporary solution to the issue and will be releasing claims report for the four quarters in SFY2019. As soon as additional information is available, it will be shared at the BOH level.
Respectfully submitted on behalf of the Senior Management Team by, Lisa Gonzalez, MPH Public Health Administrator
5/22/2019
4
VI. Division ReportsMarch to April 2019
Administration UpdateLISA GONZALEZ
5/22/2019
5
IPLAN UpdatePriority Highlight: Behavioral Health•Initiative – Trauma Informed System of Care
Cindy Graves and Lisa Gonzalez have been working closely with Jennifer Junck, PNP, Doctoral Candidate at Rush University. The initial staff training on Trauma is set for June 24, 2019. Prior to that date, we will initiate two assessments to obtain baseline data from staff. The data from the assessments will also be used to tailor the training to meet the needs of our workforce.
Following the all‐staff training, we will establish a Trauma Informed Care Advisory Committee which will provide recommendations for follow‐up training opportunities for staff and Trauma Informed Policies and Procedures.
IPLAN Update (ctd.)
Priority Highlight: Maternal and Child Health •Initiative – Basics DeKalb County
• Lisa Gonzalez worked as part of an interdisciplinary recruitment team to interview
and hire the Coordinator for the Basics DeKalb County Initiative. The Coordinator has spent her first month meeting with various community partners to begin discussions on how partners can educate the families they serve about the Basics.
The Health Department will be working in the coming months to develop a plan toincorporate the Basic messaging into their interactions with young families.
5/22/2019
6
Policy Development• Senior Leadership staff continued work on two new policies, a social media use policy and a recruitment policy. Once drafted, both policies will be reviewed by the Labor Attorney and Collective Bargaining Unit and then brought to the full Board of Health for approval.
Fiscal Updates• We have begun to receive information from our State funders for SFY2020 grant funding and application requirements. All pre‐grant requirements for SFY2020 have been completed. The program budget and Uniform Grant Agreement has been completed for the SFY2020 WIC grant.
• Administration staff continued to work towards the close out the 2018 financial reports. This year, there have been several changes/delays in grant payments and the audit has experienced various delays at the County‐level as well, therefore the presentation of the 2018 Audited Financial Statement will be moved to the July meeting agenda.
5/22/2019
7
Fiscal UpdatesFederal Match for Family Case Management (FCM) • As reported at the March 2019 meeting, IDHS has been working to determine the future sustainability of the Family Case Management Federal Match.
• We have heard from IDHS that they have identified a temporary solution to the issue and will be releasing claims report for the four quarters in SFY2019. As soon as additional information is available, it will be shared at the BOH level.
Billing UpdateBRENDA COURTNEY
5/22/2019
8
Billing• Mrs. Courtney and Accounting staff continue to work closely with CDP on a daily basis. Staff works as a team on the monthly CDP Statement Lists which indicates why claims were denied and which clients should be billed for balances due.
Health Protection UpdateGREG MAURICE
5/22/2019
9
Septic • Staff have confirmed that the 4 residences on Greenwood Acres Drive in DeKalb with illegal septic systems have disconnected from the tile.
• A contractor was able to verify that a 5th residence had an onsite system.
• We are now waiting on permit applications to be submitted for new septic systems.
Solid Waste ProgramEvents currently scheduled for 2019:◦ Electronic collection held on May 4th. ◦ Over 300 cars served and 3 semi‐trailers were filled
◦ Household Hazardous Waste collection will be held on June 8th.
◦ Electronic collection will be held on September 7th.
5/22/2019
10
Animal Control• Animal Control staff took possession of a dog at the end of March for the City of DeKalb, who charged a resident with animal cruelty.
• Animal Control was asked to review a video of the incident by the States Attorney, to provide support for additional charges.
• The dog is still being held by Animal Control pending the court case because the resident has been unwilling to relinquish ownership.
• The next court date is in June.
Community Health & Prevention, Health Promotion & Emergency Preparedness UpdateCINDY GRAVES
5/22/2019
11
Emergency Preparedness
• DCHD EP presented the Rockford Region Point of Dispensing (POD) training on April 9th. Focus was to give the participants tools to go back and train their staff on the POD principles.
Community Lab Draw Program• All nurses will be trained in phlebotomy to perform venous draws for the Community Lab Draw
pilot program. • Training will take place on Wednesday and Thursday, May 29 & 30th and staff will attend one of four
sessions (am or pm).
• Training will be completed by Jeanne Isabel (our lab director) and our representative from the UIC Health Lab who will be our reference lab. The clerical tasks will be kept with clerical staff—i.e. putting in the lab orders, payments and readying for courier.
• The CLD pilot program will service clients on Monday and Friday by appointment only. The program will be primarily based through the Family Planning Program, but all will need to support the program.
• We are anticipating a start date of July 1st.
5/22/2019
12
Family Case Management • FCM/Healthworks (DCFS), and High Risk Follow up Annual Audit completed.
• Received notification of the assigned caseloads for FY20. FCM assigned/projected caseload is 620 (an increase of 30 cases) at a reimbursement of $468/case
• High‐risk infant/Healthworks (DCFS) caseload remained at 130 at a reimbursement of $600/case.
• Concerns related to new home visit requirements for SFY2020• A home visit will be required for all pregnant women and all infants with no differentiation between Not‐at‐Risk vs At‐Risk clients. Home visits to focus on Safe Sleep/SIDS Prevention.
• For the DCHD FCM and the High Risk Infant Follow‐Up Programs:• 2018 = 75 Home Visits Required• 2020 = 1,260 Home Visits Required
Vision & Hearing• Received word that DeKalb Schools (District 428) would like to resume our arrangement of contracting for their schools’ Vision & Hearing requirements beginning in the 2019/2020 school year.
• MOU has been signed and received.
5/22/2019
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Overview
•Program Overview
•Fiscal Overview•Animal Control Authority
•Future Considerations•Questions
Animal Control – Program Overview
5/22/2019
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DeKalb County Animal Control (AC) Program
•AC Program Goal: • to prevent the spread of rabies through vaccinations and education and support a database of registered dogs and cats.
•AC staff are responsible for enforcing county ordinances and state laws pertaining to animal‐related complaints.• DeKalb County Code ‐ Chapter 10 – Animals
• Illinois Animal Control Act
• Illinois Humane Care for Animals Act
AC Program Overview• Investigations are done regarding nuisance complaints, allegations of animal cruelty or neglect, as well as reports of stray, roaming or injured animals; or dangerous, vicious or biting animals.
• Residents can obtain rabies vaccinations and tags at veterinary clinics in DeKalb County, or if the dog was vaccinated out of county, rabies tags can be obtained at the Health Department.
5/22/2019
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Management of Stray Dogs
•Stray Animal Picked Up• Checked for Microchip or other identifier
o If identity is verified, owner is contacted and immediate reunification is attempted
• If no way to identify, animal is transferred to Malta Vet for holding
o If ill or injured, basic veterinary care is administered and animal is held for up to 7 days or until claimed
o If animal is extremely ill or injured, holding time may be shortened. In these cases alternative options are explored such as working with our partner agencies to seek advanced medical treatment.
Management of Stray Dogs•After 7‐day Hold Period
• Dogs that are adoptable (not aggressive) are placed in various shelters or rescue organizations.
• Unfortunately, dogs that are aggressive cannot be placed for adoption.
• The Program ensures that all dogs transferred to local shelters have been microchipped and are current on rabies vaccination.
5/22/2019
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Management of Stray Dogs and Cats
207187
164
4254 60 61
18
0
50
100
150
200
250
2016 2017 2018 2019 (YTD)
Animal Control Data
Total Animals Handled Animals to Shelter
DeKalb County Animal Control Program
• Although the primary responsibility of the AC Program is to respond to stray dogs, we also respond in cases of sick for injured animals or by the request of local law enforcement (i.e. evictions, legal cases, hoarding, etc.)
5/22/2019
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• Paul Augustine, DVM, is the contractual Administrator of the Animal Control Program of the DeKalb County Health Department.
• Malta Veterinary Clinic provides board, minor treatment of injuries and infections, euthanasia and cremation for strays delivered to the clinic by the DeKalb County Health Department Animal Control Wardens.
Program Oversight
Animal Control ‐ Fiscal Overview
5/22/2019
20
• Registration and Pick‐up Fees• County IMRF /SS support for AC employees
• County support for the purchase of AC vehicles
Animal Control Revenue
• Personnel Expenses for AC Wardens, Secretarial and Administrative Support
• Contractual expenses for Animal Control Administrator and animal boarding/care
• Animal Control vehicle and vehicle maintenance expense
• Donations to local Animal Shelters for Spay and Neutering Programs (from revenue generated from pick‐up fees that are assessed to owners of dogs running at large)
• Other Commodities and Services for program operations (i.e. supplies, phones, fuel, postage, technology, etc.)
Animal Control Expenditures
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• Contractual payments for AC Services are issued as follows:• The AC Administrator is paid an annual amount to provide program oversight. Annual payment is dispersed in 2 equal payments in March and July.
• The Veterinary Clinic is paid an annual amount for boarding and basic veterinary care. Amount is dispersed in 12 equal payments throughout the calendar year.
• At the end of the year, a reconciliation is conducted to ensure that what was paid ties out to the actual services rendered and annual amount is adjusted (up or down) if necessary.
Contractual
Animal Control ‐ Authority
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•Animal Control has the authority to:• Ensure that
• all domesticated dogs are vaccinated against Rabies and have a DeKalb County Rabies Tag.• all reported animal bites are given precautionary attention in relation to the possibility rabies infection.
• pet owners are instructed on proper procedures pertaining to animal bites and enforce
adherence to these procedures.• Contain loose/stray dogs in DeKalb County, primarily in unincorporated parts of the county.
• Investigate nuisance dog complaints in unincorporated DeKalb County.• Work with local law enforcement agencies to investigate complaints of neglected and/or abused dogs that fall within AC authority.
Animal Control Authority
• In potential criminal cases of animal cruelty or neglect, AC must involve the local law enforcement and/or the States Attorney Office.
• Animal Control does not currently have the authority to mandate Rabies vaccination for any other pets (i.e. cats, ferrets)
• Animal Control does not have authority to inspect the premises of a Department of Agriculture licensee to determine compliance with the Animal Welfare Act.
Animal Control Authority
Inspection of the premises of a licensee to determine compliance with this Act may be made only by the Department.
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Future Programmatic Considerations
• Strengthen the contractual agreement for Animal Control Services including contract for Animal Control Administrator and for boarding/veterinary care.
• Determine feasibility of putting Animal Control contracts out to bid.
• Reassess local shelter capacity for transfer of stray animals processed through Animal Control.
• Explore the possibility of utilizing the new HealthSpace software for data collection.
• Assess the local veterinarians and Board opinion on expanding the local Animal Control Ordinance to include cats and/or ferrets.
Animal Control – Future Considerations
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