Licking County Health Department County Health Department . ... Public Health Nursing / Child and Family Health ... reduce mosquito breeding sites on their property in order to reduce

Licking County Health Department 675 Price Rd., Newark OH 43055 (740) 349-6535, www.lickingcohealth.org R. Joseph Ebel R.S., M.S., M.B.A, Health Commissioner

R. Joseph Ebel R.S., M.S., M.B.A

Health Commissioner Report

Like many public agencies, the Licking County Health Department experienced an increase in retirements of long-term employees in 2012. We took this opportunity to reassess our staffing needs and as a result we consolidated some management positions and reduced overall staffing levels. This resulted in cost savings that allowed us to better focus our resources on meeting the public health needs in Licking County.

Quality improvement and health assessment remain a priority for LCHD, and in 2012:

• We held 5 focus groups around the county to find out what the public thinks the health needs are in Licking County.

• Received Quality Improvement grant funds from the National Network of Public Health Institutes to evaluate and improve our medical supply inventory and ordering system.

• Compiled results of our 2011 Behavioral Risk Factor System survey and updated our Community Health Assessment report.

• Contracted with Wright State University to call 500 households to collect data for our 2012 Behavioral Risk Factor System survey.

2012 Highlights/Challenges

• Well, Sewage, and Plumbing permits can now be accessed on-line. We hope that this will be a valuable service for homeowners, realtors, and contractors. Visit our website at www.lickingcohealth.org to search for permits based on addresses.

• Added a grant writer to our staff improving our ability to bring state, federal, and non-profit funding into Licking County to enhance public health services.

• Expanded on our annual Bike Ride event to include stops in Newark, Granville, Alexandria, and Johnstown.

• Improved Communication o Over 48,000 visits by over 30,000 visitors to our websites in 2012. o Upgraded our email messaging and alert system, with 1,575 subscribers. o Built our social networking presence with 2,280 following us on Facebook and 129

Twitter followers.

Board of Health

Management Team

Administration

Rod Ellis

Mona Myers R.N.

Pat Smith R.N.

Patrick Scarpitti M.D.

Phil Mitchell

Gary Wood

Tom Mullady

Neisha Grubaugh

Jim Glover

Carole Wachtel

Craig Dyer D.C.

Raymond Wagner retired from the board in 2012 after 21 years of service.

R. Joseph Ebel R.S., M.S., M.B.A. Health Commissioner

Dr. Charles Marty Medical Director

Barbara Lanthorn Administrative Services Director/Registrar

Todd Kirkpatrick M.S., R.D., L.D. WIC and Health Promotion Director

Mary Beth Hagstad R.N., M.S.N., C.N.S. Nursing/Child and Family Health Director

Chad Brown R.S., M.P.H. Env. Health Dir./Deputy Health Commissioner

Nancy Hanger R.N., Nursing Director, and Robert Sealock R.S., Environmental Health Director, both retired from the department in 2012.

Public Health Poster

Contest Winners Ray Wagner

Public Health Guardian Licking River Round-up

Public Health Planning, Preparedness, and Quality Improvement Public health preparedness for bioterrorism, epidemics and other public health threats and emergencies involves all areas of the Department. Emergency management and response functions are integrated into each program and into each employee’s job duties. Our staff conducts disease surveillance and our epidemiology team investigates disease outbreaks and evaluates our disease surveillance processes.

LCHD began working toward a culture of quality in our organization in 2010. Quality improvement in public health is the use of a deliberate and defined improvement process such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health. It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.

• Improved our weekly influenza report to provide a clear understanding of the number of influenza cases diagnosed each week.

• Received funding from state and national sources to implement 2 quality improvement projects.

• Updated our Community Health Assessment with current and relevant data.

• Continued the process of pursuing national accreditation.

• Coordinated the Licking County Community Health Improvement Committee and updated the Licking County Community Health Improvement Plan.

• Conducted 2 exercises with community partners to test our emergency preparedness capabilities in the event of a bio-terrorism attack.

• Held 5 focus groups around the county in order to receive feedback regarding the top public health concerns in Licking County.

• Developed a Healthcare Access Assessment designed to identify gaps in the healthcare system in the county.

• Collaborated with several entities to improve the overall preparedness level in the county to respond to a natural disaster.

• Enhanced our ability to seek and obtain funding from a variety of sources with the addition of a Grant Writer.

• Updated our Emergency Response and Pandemic Influenza Plans.

Public Health Nursing / Child and Family Health Services

Highlights:

• Nurses staffed Cooling Station shelters during the storm related power outages in July. • Provided a nurse to work 19 days at the Community Health Clinic.

At-Risk Pregnancy Program: Provides education and counseling to pregnant women and new moms. The goal of this program is for the clients to experience a healthy pregnancy and delivery, and equip them to care for their newborn child.

Breast and Cervical Cancer Project: Provides education, screening, re-screening, diagnostics and case

Nursing/CFHS Programs 2012

Clients Attending Clinics 5,657

Immunization (# of Children) 2,190

International Travel Vaccine Clients 434

Adult Vaccines (various) 707

Adult Flu Vaccines 1,694

STD/Sexual Health Clinic visits 632

Total Doses of Vaccine Administered

Children 5,416

Adult 1,984

Adult Flu 1,694

STD Clinic 118

TB Tests 720

HIV Tests 476

Dental Sealants Applied 1,333

Help Me Grow Home Visits 167

At-Risk Pregnancy Consultations 2,117

Home Health Visits 166

Lead Poisoning Prevention Home Visits 11

Early Head Start Home Visits 2,111

Breast and Cervical Cancer Program Participants 1,419

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Licking Co. Gonorrhea Trends

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management related to breast and cervical cancer in an eight county central Ohio region. Women are eligible for the BCCP if they meet the following: •Live in households with incomes less than 200 percent of the poverty level, and •Are uninsured, and •Are 40 years of age or older to receive Pap tests and clinical breast exams, or •Are 50 years of age or older to receive mammograms.

Dental Sealants: Provides free dental screenings, oral health education, and dental sealants to 2nd and 6th grade students in income qualifying districts. Sealants seal the tops of molars, reducing the risk of cavities. Newark City Schools, Mt. Gilead (Park Avenue Elementary), Mt. Vernon City (Twin Oak Elementary), Par Excellence Academy Elementary, Ridgewood (West Lafayette Elementary), River View School District (Union Elementary & Warsaw Elementary).

Early Head Start Program: This program works with low income families with children under three years old to provide parenting training and to work with the children to make sure that they are developing properly.

Women’s Health – Breast and Cervical Cancer Exams: LCHD has become a BCCP service provider, offering breast exams and pap tests when referred through the BCCP project.

Traveler’s Health: Consultations and Vaccinations for International Travelers are available through our clinic.

BCMH – Bureau for Children with Medical Handicaps: Assists Licking County families with children who have special needs.

Flu Shots – An earlier than usual flu season in the Fall and early Winter of 2012 highlighted the need for annual flu vaccinations. Flu shots were provided at no charge to residents without health insurance.

STD/Sexual Health Clinic: Free STD and HIV testing and education is provided on Tuesday afternoons and evenings at our Price Rd. location.

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Licking Co. Chlamydia Trends

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Health Promotion We’re Active Licking County wellness program promotes physical activity and proper nutrition. Activities include: Wellness Coalition meetings, Pink Strides Trail Run and Wellness Walk, Change Gears Bike Ride (108 participants), Worksite Wellness Workshop (30 attendees), www.lickingcohealth.org/wellness/index.html and www.trail2health.org websites.

Child Safety Seats: In 2012 our technicians did 89 car seat checks, taught 17 car seat classes, and provided low income residents with 49 free car seats.

We Thrive! Wellness program encouraging tobacco-free campus policies for publicly owned property and child care centers. Assisted 3 child care centers in adopting Wellness policies.

Grow it Try it Like it: 135 children in 3 childcare centers participated in six lessons. The six lessons included spinach, squash, sweet potato, cantaloupe, and strawberry and peaches. Children tasted, grew, and learned about each food.

Partners in Wellness: 3rd Grade Health and Wellness program. Provides lessons every two weeks on a variety of topics including nutrition, exercise, handwashing, and bullying prevention to 1,400 students in Granville, Johnstown, Licking Valley, Heath, Lakewood, Licking Heights, North Fork, Northridge, Par Excellence, and Granville Christian Academy.

Safe Communities: Traffic Safety program provides motorcycle safety, drunk and drugged driving prevention, seat belt “Click it or Ticket” campaign, Drive Sober or Get Pulled Over, and other initiatives. A Health Educator participated in the “Drive Alive” exhibit committee at The Works.

Tobacco Prevention: Kickin’ Ash Splash tobacco free pool party was attended by over 1,200 people. Promoted tobacco-free schools, and assisted 1 school in passing tobacco-free school campus policies, bringing the total tobacco-free schools in Licking County to 7.

SASS – Screening and Social Support for Breast Cancer Program: www.lcsass.org • Enrolled 40 new women (215 women total in program). • Provided 191 screening mammograms and 54 diagnostic

follow-up procedures mammograms and ultra sounds. • Provided $25,115.08 in medical reimbursements to 37 unduplicated women diagnosed

with breast cancer. • Spring into Pink and Summer Update programs attended by approximately 140 cancer

survivors and supporters. Pink Strides Trail Run/Walk had 126 participants in spite of the cold and rainy weather.

• Rally for the Cure: Moundbuilder’s Country Club event raised a net profit of $22,020.25 • Health Fairs and Events: Health Educators attended 31 health fairs and events at

employers, schools, and other locations. LCHD participated in the Utica Ice Cream Festival Parade, Granville 4th of July parade, Johnstown Firefighters parade, and Newark Jaycees parade. 133 Tobacco Prevention commercials aired through WeThrive! project.

Environmental Health

Food Safety Education In 2012, we held a total of 4 Level I Certification in Food Safety courses, and certified over 85 individuals. Providing education to food service workers in the county is a vital part of our Food Safety Program, and it plays a big role in preventing foodborne illness outbreaks.

Sewage Treatment System Education During the summer of 2012, we conducted the Sewage and Wastewater Elimination Education Program (SWEEP) to educate homeowners regarding the importance of septic system maintenance. The program involved sending almost 10,000 mailings to homeowners with sewage systems in the county containing educational information. We also held 3 homeowner education workshops to provide firsthand education to homeowners about their systems. The program received national attention and is currently featured as part of the USEPA’s SepticSmart program. The SWEEP project was made possible through a grant from the Ohio Environmental Education Fund.

Mosquito Control In 2012, we identified 118 pools, or groups,

of mosquitoes infected with West Nile Virus (WNV). Our staff conducted control measures designed to combat mosquitoes as larvae and adults. We also provided education to numerous homeowners regarding how to reduce mosquito breeding sites on their property in order to reduce their chances of contracting WNV.

Environmental Health Statistics Permits Inspections Consultations Food Service Operations 512 1760 795 Food Establishments 176 538 502 Mobile 92 355 84 Vending 116 122 10 Temporary Food Event 158 152 45 Manufactured Home Park 35 86 22 Campground 18 32 9 Resident and Day Camps 8 10 1 Pools and Spas 77 506 26 Bathing Beaches 1 3 2 Waste Facility 2 72 31 Schools 69 143 59 Tattoo/Body Piercing 12 18 14 New Sewage Installations 56 120 178 Sewage Alterations 34 40 20 Existing Sewage Systems 74 98 Semi-Public Sewage 347 410 12 Private Water Systems 166 179 71 Plumbing Residential 402 908 44 Plumbing Commercial 137 446 39 Backflow Prevention 1521 Water Samples Collected 579 Nuisance Complaints Complaints Inspect/Consult Solid Waste 535 638 Sewage 46 78 Food 147 101 Smoking 20 95 Other 32 48 Total 779 960 Rabies / Animal Bites 383

Dog 277 Cat 88

Raccoon 8 Other 10

Mosquito Control 248 traps; 14,344 mosquitoes collected West Nile Virus 118 positive pools

Miles of Spraying 866

Environmental Health Permits/Complaints by Political Subdivision Political Subdivision

Sewage Permits

Well* Permits

Plumbing Residential

Plumbing Commercial

Nuisance Complaints

Animal Bites

Food** Permits

Visits All EH Programs

Alexandria 0 0 1 0 0 0 5 37 Bennington 4 2 5 2 1 0 4 69 Bowling Green 1 3 2 0 6 1 0 72 Buckeye Lake 0 12 26 4 17 11 29 297 Burlington 4 6 3 0 3 3 3 55 Croton 0 1 0 0 3 1 15 40 Eden 0 2 0 0 3 2 6 50 Etna 1 0 65 2 13 8 39 495 Fallsbury 1 4 2 0 0 0 3 54 Franklin 3 8 2 0 1 2 0 66 Granville Twp. 13 11 15 3 7 30 27 501 Granville Village 0 0 9 5 1 1 41 304 Gratiot 0 0 0 0 0 0 0 19 Hanover Twp. 3 9 10 0 4 9 10 149 Hanover Village 0 7 5 1 1 0 13 64 Harrison 4 0 22 2 6 0 9 270 Hartford 3 6 3 0 2 2 0 138 Heath 1 0 6 20 59 21 131 831 Hebron 0 0 2 4 4 1 31 199 Hopewell 2 1 2 0 0 3 2 34 Jersey 7 10 5 1 2 2 6 126 Johnstown 0 0 2 4 6 0 46 252 Kirkersville 0 1 1 1 3 0 3 57 Liberty 7 11 4 0 3 1 10 136 Licking 5 10 11 7 16 6 49 321 Madison 9 11 2 0 7 10 5 161 Mary Ann 1 1 0 0 9 3 3 149 McKean 7 11 6 0 1 0 5 123 Monroe 4 5 21 1 5 10 2 146 Newark Twp. 1 2 2 0 2 8 3 87 Newark City 2 1 105 61 508 138 315 3,931 Newton 4 3 2 2 5 4 3 142 Pataskala 3 4 29 8 26 56 100 708 Perry 3 3 3 0 0 2 0 45 St. Albans 6 3 2 1 2 3 2 74 St. Louisville 0 0 0 0 2 1 5 24 Union 13 16 19 4 11 6 36 349 Utica 0 0 2 2 8 0 26 120 Washington 0 1 4 2 0 11 9 72 Totals 112 166 402 137 779 383 1,016 10,767

*Well permits include new, alteration, and abandonment permits. **Food includes Food Service, Retail Food Establishments, Mobile, Vending, and Temporary.

WIC – Women, Infants, and Children Licking County’s Women, Infants, and Children’s Supplemental Nutrition Program (WIC) provides nutrition education and screening, supplemental foods, breastfeeding support, and referrals to women (pregnant, postpartum, and breastfeeding), infants, and children less than 5 years old.

• $2,159,239 was spent in 2012 on groceries purchased with Licking County WIC coupons.

• Promotion of on-line nutrition education at www.wichealth.org (anyone can use site) • Distribution of $4,875.00 (325 booklets, each containing

five - $3.00 coupons) in our 9th year of the Farmers Market Nutrition Program

• Added “Partners in Breastfeeding” support group meetings to complement our existing Breastfeeding Class

Vital Statistics – Birth and Death Records Birth and Deaths occurring in Licking County are recorded by the Registrar, and certified copies of both are available for purchase.

Licking County Health Department has Statewide Access for electronic birth certificates. Through this program we can issue a birth certificate as long as the person was born in Ohio.

2012 Births: 1,101 Deaths: 1,259

77 Children, or 7 %, were born to mothers under 18 years old.

129 Children, or 12 %, were born to mothers less than 20 years old.

Most popular names for children born in Licking County during 2012: Boys # Girls #

Caseload Monthly Average Total 3505 LCHD 2650 Buckeye Lake 169 Pataskala 498 Johnstown 188

Bentley 10 Emma 11 Mason 10 Isabella 10 Braxton 7 Layla 5 Eli 7 Lillian 5 Logan 7 Olivia 5 Brayden 6 Sophia 5 Colton 6 Zoey 5 Jackson 6 Emily 4 Liam 6 Jasmine 4 Mitchell 6 Madison 4

Expenses Financial Summary

PERSONNEL COSTS EQUIPMENT COSTS

SALARIES 2,585,266 EQUIPMENT 79,552

HEALTH INSURANCE 453,835 SUBTOTAL 79,552

OPERS - PENSION 672,189

WORKERS COMP 45,039

UNEMPLOYMENT 11,843 CONTRACT SERVICES COSTS

MEDICARE 35,054 CONTRACT SERVICES 248,149

SUBTOTAL 3,803,226 WIC CONTRACT SERVICES 2,330

SUBTOTAL 250,480

SUPPLIES COSTS

OFFICE SUPPLIES 79,652

MEDICAL SUPPLIES 90,152 OTHER EXPENSES COSTS

GRANT SUPPLIES 54,453 OTHER EXPENSE (AUDIT) 10,849

MOSQUITO CONTROL SUPPLIES 5,540 PROFESSIONAL ED & DUES 20,683

WIC SUPPLIES 2,235 STATE REMITTANCE 187,729

SEWAGE SUPPLIES 300 WATER SAMPLES 10,695

SUBTOTAL 232,331 TB OTHER EXPENSES 1,686

REFUNDS 6,775

TRAVEL/FUEL 8,829

BOARD MEMBER EXPENSE 7760

LOCAL REMITTANCE 2429.22

SUBTOTAL 257,435

$4,623,025TOTAL EXPENSES

82%

2%5%

5%6%

Income Financial Summary

GRANTS VALUE FEES AND CHARGES VALUE

CHILD AND FAMILY HEALTH 48,270 CONTRACT SERVICES 114,328

HELP ME GROW 73,125 PLUMBING PERMITS 250,257

HEALTH PROMOTION 10,810 VITAL STATISTICS (BIRTH/DEATH) 235,781

EARLY HEAD START 283,500 AT RISK PREGNANCY NURSE 44,642

TOBACCO COMPLIANCE 2,430 CHILDREN W/MEDICAL HANDICAPS 53,570

RADON 42,000 IMMUNIZATIONS 191,596

SAFE COMMUNITIES 27,334 FOOD SERVICE LICENSE 314,094

IMMUNIZATION ACTION PLAN 43,830 PRIVATE WATER SYSTEMS 64,898

KIDS CAR SEATS 5,000 CONSTRUCTION & DEMO DEBRIS 39,440

PUBLIC HEALTH PREPAREDNESS 151,293 SEWAGE TREATMENT SYSTEMS 96,651

BREAST AND CERIVCAL CANCER 188,621 MEDICAID ADMIN CLAIMING 65,201

MEDICAL RESERVE CORPS 5,000 TB CONTROL 39,256

DENTAL SEALANTS 67,339 PUBLIC SWIMMING POOLS 29,955

BREAST CANCER 87,944 MOSQUITO CONTROL 23,979

WIC NUTRITION PROGRAM 540,833 CLINICAL SERVICES 6,435

SOLID WASTE ENFORCEMENT 50,000 SOLID WASTE FEES 19,338

MINI GRANTS 29,566 OTHER - MISC. 51,266

TOBACCO PREVENTION 52,441 FEES TOTAL 1,640,687

GRANTS TOTAL 1,709,336

LOCAL SUPPORT VALUE

NEWARK CITY 888,886

STATE OF OHIO VALUE PATASKALA CITY 61,500

STATE SUBSIDY 29,502 HEATH CITY 56,500

STATE TOTAL 29,502 TOWNSHIPS AND VILLAGES 358,000

LOCAL TOTAL 1,364,886

$4,744,411TOTAL INCOME

36%

34%

1%

29%

What is public health? The World Health Organization defines public health as “the science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.” The public health system is made up of government agencies and private organizations that work to: Prevent epidemics and the spread of disease Protect against environmental hazards Prevent injuries Promote and support healthy behaviors Respond to disasters and assist communities in recovery Assure the quality and accessibility of health services

Although public health organizations work closely with medical and social service providers, the field of public health is distinctly focused on prevention of health problems before they occur, populations and groups rather than individual patients, and all factors that affect health, including socio-economic factors and the physical environment. Licking County Health Dept. 675 Price Rd. Newark, OH 43055