WAKE COUNTY HUMAN SERVICES - Wake County, North …...An Overview of Wake County Human Services Leadership Page 1 Vision, Mission and Values Page 2 ... Human Capital Development -

WAKE CO UNTY

HUMAN SERVICES A R e v i e w o f F i s c a l Ye a r 2 0 1 5

Wake County Human Services

220 Swinburne St, Raleigh NC

919-212-7000

#PeopleFirst

Section I. An Overview of Wake County Human Services

Leadership Page 1

Vision, Mission and Values Page 2

Service Numbers Page 3

Accomplishments Page 4

Locations Page 5

Wake County Human Services Budget Page 6

Human Services Board Page 7

Major Board Initiatives Page 8

TABLE OF CONTENTS

Section II. Trends and Horizons

Wake County By the Numbers Pages 9-11

Current Challenges for Human Services Pages 12-14

Section III.

Trends by Program or Service

Wake County Human Services Trends Page 14-33

Adult Medicaid Program Trend 2008-2015 Page 15

Adult Guardianship Program Trend 2008-2015 Page 16

Adult Protective Services (APS) Program Trend 2011-2015 Page 17

Child Protective Services (CPS) Accepted Assessments Trend 2008-2015 Page 18

Child Protective Services (CPS) New In Home Service Case Trend 2008-2015 Page 19

Foster Care Program New Children Entering Custody Trend 2008-2015 Page 20

Child Care Subsidy Program Trend 2008-2015 Page 21

Child Care Subsidy Wait List Trend 2008-2015 Page 22

Family and Children’s Medicaid Program Trend 2008-2015 Page 23

Food and Nutrition Services (FNS) Program Trend 2008-2015 Page 24

Employment Services Swinburne Center Trend 2008-2015 Page 25

Immunization Program Trend 2008-2015 Page 26

Women, Infants and Children (WIC) Program Trend 2008-2015 Page 27

Family Planning Program Trend 2008-2015 Page 28

Vital Records Births and Deaths Trend 2008-2014 Page 29

Syphilis, HIV & AIDS, Gonorrhea and Chlamydia Services 2008-2014 Page 30-31

Wake Coordinated Transportation Services (WCTS) Trend 2011-2015 Page 32

Customer Support Call Center Trend Monthly 2015 Page 33

Summary Table - End of Year Case Counts by Program or Service Indicator Page 34

LEADERSHIP

We hope you find the information in this report useful. Wake County has over 1 million

residents, and many more who commute into the County every day. Please call us if you

have questions about Human Services. I would like to hear from you about any community

events where we can participate or be a partner. We are especially interested in ongoing

partnerships that help families be safe, healthy, and move to higher levels of self–sufficiency. I

would like to thank the hundreds of community partners who help make living in Wake County

better every day.

You can reach my office at 919-212-7302 if you have any questions or feedback for us.

G R E E T I N G S F R O M

WAK E C O U N T Y H U M AN S E RV I C E S !

Starting March 12, 2015

R E G I N A P E T T E WAY

Human Services Director

22 years experience with Wake County Human

Services (WCHS)

W C H S B O AR D E S TAB L I S H E S T O P

P R I O R I T I E S :

Healthy Behaviors – Public Health Committee

Human Capital Development - Social Services Committee

Page 1

OUR VISION Wake County will be one of the healthiest places to live and all residents

will have opportunities to improve their lives.

OUR MISSION Wake County Human Services, in partnership with the community, will

facilitate full access to high quality and effective health and human

services for Wake County residents.

OUR VALUES Accountability

Community Partnerships

Ethical Behavior

Open Communication

Our Employees

Prevention

Proactive and Strategic Thinking

Providing Accessible Services

Providing Great Customer Service

Providing Quality Services

Respect for All

Page 2

VISION, MISSION AND VALUES

569,889 Customer Support

Call Center Calls

221,394 Transportation

Services

3,239 Pediatric Clients

367 New Foster Care

Placements

7,011 Child Care Subsidy

Clients

39,371 Food and Nutrition

Assistance

Households

743 Adult Guardianship

Wards

89,819 Medicaid Clients

9,753

Dental Patients2

15,988 Immunization

Clients

16,891 WIC Clients

7,394 Family Planning

Clients

5,927 Sexually Transmitted

Infection Diagnoses1

5,817 Child Protective

Service Assessments

18,791 Vital Records

Processed

19,790 Capital Area

Workforce Center at

Swinburne New and

Repeat Clients

At Least 150,000 Individuals Served by WCHS in 2015

60 Adoptions Finalized

Page 3 1Combined figure for four infection types 2Figure adjusted April 13, 2016

SERVI CE NUM BERS

ACCOMPLISHMENTS

QUALITY MANAGEMENT Increased compliance of Influenza

Vaccination for EMS & Public Health

divisions to almost 100%

Developed a presumptive Medicaid

screening process to enroll qualifying

patients with a projected revenue

increase close to $300,000 per year

CHILD WELFARE 199 children left foster care for

permanent placements of that, 65

were reunified with a parent

120 young people were served by

Fostering Youth Opportunities (FYO)

collaborative

30 Foster youth graduated High

School

HOUSING & TRANSPORTATION 39 people trained through the South

Wilmington Street Center

employment project; 22 secured

competitive employment

178,407 trips provided by Wake

Coordinated Transportation Services

(WCTS)

HEALTH CLINICS 87% immunization rate for 3,237

children seen through the Pediatric

clinic, exceeding NC immunization

goals of 86%

$13,500,000 in donated medications

used to assist Pharmacy clients

Page 4

SOCIAL SERVICES $3 million spent to assist 13,176

Households with summer and winter

energy bills

PUBLIC HEALTH Awarded Certificate of Excellence by

Wake County Council on Fitness &

Health for Movin’ & Groovin’ Walking

Series

Six local farmers markets certified to

accept Electronic Benefit Transfer

(EBT) cards

CHILD, YOUTH & FAMILY (CYF) Awarded $40,000 grant for “Respite

Services” to assist families at-risk

for child victimization

Women , Infant, Children Program

(WIC) received National Association

of Counties (NACo) Award for

Innovative technology

SCHOOL NURSE PROGRAM 22,494 WCPSS1 students served

11,658 students screened by school

dental hygienist

1Wake County Public School System

SWINBURNE CENTER

208,930 Visitors in FY15

WAKE CO UNTY

HUMAN SERVICES LOCATIONS

Estimated Volume of Visits

WESTERN SERVICES


SOUTHERN REGIONAL CENTER


SOUTH WILMINGTON STREET CENTER

92,787 Overnight stays in FY15 (actual)

CROSBY—GARFIELD CENTER


Disclaimer – Estimates reflect number of visits to location, not people served. Page 5

EASTERN REGIONAL CENTER


SUNNYBROOK


MILLBROOK CENTER


NORTHERN REGIONAL CENTER


WAKE CO UNTY

HUMAN SERVICES BUDGET

Full Time Equivalent

(FTE)

Positions

1,443.16 Actual FY 2015

and

Adopted FY 2016

$108,838,722

$194,603,433

$85,764,711

Actual FY 2015 Budget

REVENUE TOTAL

EXPENDITURE TOTAL

COUNTY APPROPRIATION

$104,932,288

$193,006,572

$88,074,284 Adopted

FY 2016 Budget

REVENUE TOTAL

EXPENDITURE TOTAL

COUNTY APPROPRIATION

Page 6

WAKE COUNTY HUMAN SERVICES BOARD

From Back Row Left: Commissioner James West, Mayor Frank

Eagles, Dr. Sharon Foster, Pablo Escobar, Kent Jackson, Seth Wexlar

and John Myhre

From Front Row Left: Regina Petteway, Fiorella Horna-Guerra,

Stephanie Treadway, Dr. Jacqueline Tavarez, Margaret Raynor, and Dr.

Jim Smith

Not Pictured: Leila Goodwin, Dr. Rosine Sanders, Dr. Paul Scruggs,

Angie Welsh, and McKinley Wooten

2014 - 2015

Board Priorities (January, 2014)

Healthy Behaviors – Public Health Committee

Human Capital Development - Social Services

Page 7

MAJOR BOARD INITIATIVES

HEALTHIEST CAPITAL COUNTY INITIATIVE

(HCCI) Accomplishment: secured commitment from three community organizations to convene stakeholders to address Child Poverty High School Graduation five measures High Risk Youth Behavior Adult Obesity along with Physical activity Food Environment

COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INITIATIVE The CHNA is a collaborative effort among Wake County Human Services; WakeMed Health & Hospitals, Duke Raleigh Hospital and UNC Rex Healthcare; Advance Community Health (formerly known as Wake Health Services); United Way of the Greater Triangle; and Wake County Medical Society Community Health Foundation.

SUMMER FOOD SERVICE INITIATIVE Accomplishment: increased the number of sites and meals served to children under age 18 Over 30 sites were added in 2015 306,319 meals were served in 2015 (an increase of

37,077 meals over 2014)

HUMAN CAPITAL DEVELOPMENT (HCD) Accomplishment: convened ‘Get Connected’ summit for different public, community, faith based organizations and committees 106 individuals from 67 organizations and the

community attended this human capital development networking event

Page 8

Trends & Horizon Issues | Human Services Annual Report 2015 December 18, 2015

Page 9

Section II. Wake County By the Numbers Population Wake County is the 44th Largest County in the US with an estimated population of 998,691 in July 1, 2014. Wake County is home to four of North Carolinas’ Largest Municipalities: #2 City of Raleigh; #7 Town of Cary; #22 Town of Apex and #28 Town of Wake Forest.

Personal Economics • Unemployment rate, July 2015: US 5.3%; NC 5.9%; Wake 5.2% • Educational attainment, 25 years or over with bachelor’s degree or higher: US

28.8%; NC 28.4%; Wake 49.1% • Median household income: US $65,160; NC $45,906; Wake $65,160 • Poverty rate: US 11.6%; NC 17.9%; Wake10.7% • Median age in years: US 37.7; NC 38.2; Wake 35.5

On the Horizon Changing demographics can drive trends and impact the need for services. Some national trends with the potential to impact Wake County services include:

• Increase in the population over age 65 • Increase in ethnic diversity of general population • Increase in multiple generations in the workforce • Increase in poverty among seniors • Increase in need for housing and services that support healthy aging • Change in fertility rates

Sources: WCBTN Database, most current yearly figure as of retrieval date, September 14, 2015. http://www.wakegov.com/data/bythenumbers/Pages/default.aspx U. S. Census Bureau, American Community Survey 5-Year and 1-Year Estimates. http://factfinder2.census.gov

http://www.wakegov.com/data/bythenumbers/Pages/default.aspx

http://www.wakegov.com/data/bythenumbers/Pages/default.aspx

http://factfinder2.census.gov/

http://173.254.8.192/hsannualreport/wp-content/uploads/2014/09/trends_banner.jpg


Page 10

Trending Locally: Growth, Diversity and Transportation Wake County trends are reported in the annual Trends and Outlook, May 2015 document presented by Wake County Planning Board. The document helps paint a picture of the area using statistics and graphics. Some trending issues included in this report:

• Growth in general population

• Growth in population over age 55


Page 11

• Increase in diversity in general population

• Increase in public bus ridership (this figure does not include annual WCTS/TRACS ridership, see page 24 for Wake Coordinated Transpiration ridership data)

Source: Trends and Outlook, May 2015, http://www.wakegov.com/data/bythenumbers/Documents/trends2015.pdf

http://www.wakegov.com/data/bythenumbers/Documents/trends2015.pdf


Page 12

Current Challenges for Human Services Horizon issues with implications for human service programming:

• Need for and access to affordable housing • Need for and access to transportation • Increase in intentional and unintentional bodily injury • Increase in Syphilis rates • Increase in Heroin deaths and death rates • Births to mothers using WIC and Medicaid

Human Services: Population Based Challenges

From 2008 to 2014, the Wake County general population changed by 17%. This number is calculated by comparing the estimated population in 2008 to the estimated population as of July 1, 2014. Every year from 2008 through 2014, the estimated population figure was larger than the year before. • On average the population of Wake County has grown by 2.4% every year since

2010, see Table 1 for County population as of July 1 of each year

Table 1

Year Wake Population Calculated Change in July 1 Population 2010 906,908 Base year 2011 929,330 2.5 % change from July 2010 to July 2011 2012 952,611 2.5 % change from July 2011 to July 2012 2013 975,024 2.4 % change from July 2012 to July 2013 2014 998,691 2.4 % change from July 2013 to July 2014

Implications for Wake Human Services

• As the population increases, the number of consumers seeking services will likely increase. The ability to respond to community crises and outbreaks is also impacted by population growth.

• Potential issues related to food access may increase. The 2010 Census revealed that Wake County had a ‘Low Access’ population of 321,771, defined as


Page 13

people living more than 1 mile from a supermarket or large grocery store in an urban area (321,771 people out of total population of 900,993 in 2010 Census).

• Potential issues related to lack of affordable housing in Raleigh/Wake County may increase; in particular, for folks with criminal and /or credit issues.

• Wake County is experiencing the worst Syphilis outbreak in nearly 20 years, see Figure 1

Figure 1 Source: http://epi.publichealth.nc.gov/cd/stds/

• Since 2011, heroin deaths and death rates have more than quadrupled, see

Figure 2

Figure 2 Source: NC DHHS, Division of Public Health, Injury and Violence Prevention Branch; *2014 data is provisional

• In the five year period from 2008-2012, 64,024 children were born to mothers

living in Wake County. Over ¼ of the births were to mothers using Medicaid or WIC

o 36.3% (23,241) births were to mothers receiving Medicaid o 29.3% (18,789) births were to mothers receiving WIC

79 70 81 102

171

8.7 7.5 8.5 10.7 17.1 0

50

100

150

200

2010 2011 2012 2013 2014

Cou

nt C

ases

Early Syphilis Case Counts and Rates per 100,000 pop., Wake County, 2010-2014

Early SyphilisCase Counts

Case Rate per100,000 pop

2 6 8

16

26

0.2 0.6 0.8 1.6 2.6 0

10

20

30

2010 2011 2012 2013 2014Cou

nt D

eath

s

Heroin Deaths and Death Rate, Wake County, 2010-2014*

Deaths Death Rate per 100,000 pop

http://epi.publichealth.nc.gov/cd/stds/


Page 14

Source: NC DHHS State Center for Health Statistics Births to Medicaid and WIC Mothers, 2008-2012

• Live Birth Rates are higher for ‘Hispanic’ than ‘Non-Hispanic’ populations in North Carolina, Mecklenburg and Wake Counties for 2010-2014; See Table 2

Table 2

Source: NC-DHHS State Center for Health Statistics http://www.schs.state.nc.us/data/databook/CD3%20Live%20birth%20rates.html

Section III.

Wake County Human Services Trends Wake County Human Services July 1, 2008-June 30, 2015 Annual End of Year Case Count Updates with Trend Data Wake County Human Services Board receives an annual case load report on selected programs. Case load trends are tracked using End of Fiscal Year Case Count for each program using a selected indicator. Some programs new to this report use End of Calendar Year counts. The percent (%) change from 2008 to 2015 (not all programs have data from 2008) is a point of comparison as to whether or not programs are growing at the same pace as the population of Wake County. This report shows decreased growth in a program or service as a negative number (or -% change) and increased growth is shown as a positive number (or +% change). Trend graphs and information about programs are found on pages 15-31. Additional trend information and graphs are on pages 32 and 33 for Wake Coordinated Transportation (WCTS) Ridership and the Customer Support Call Center. A WCHS trend data table is available as an attachment on page 34.

North Carolina Resident Live Birth Rates per 1,000 Population, 2010-2014

County of Residence Non-Hispanic Hispanic

Total Total Total Births Rate Births Rate Births Rate

North Carolina 602,403 12.4 512,222 11.5 90,181 21.3 Mecklenburg 69,706 14.4 56,601 13.4 13,105 21.8 Wake 62,546 13.1 52,759 12.3 9,787 20.8

http://www.schs.state.nc.us/data/databook/CD7D%20Medicaid%20and%20WIC%20births.html

http://www.schs.state.nc.us/data/databook/CD3%20Live%20birth%20rates.html


Page 15

Adult Services

Adult Medicaid Program Trend 2008-2015 Individuals Served: End of Fiscal Year Open Case Count Comparison

• FY14 vs. FY15 +28% change • FY08 vs. FY15 +67% change • The case count has grown every year from 2008-2015. The case count changed by

an average of +8% each year from 2008 to 2014, with a larger increase in growth is seen from 2014 to 2015.

Figure 3

18,352 18,960 19,997 21,051

22,088 22,907 23,941

30,594

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

Coun

t Clie

nts o

n Ju

ne 3

0

Wake County Adult Medicaid Program End of FY Case Count 2008-2015

Source: Wake County Human Services Adult Medicaid Program


Page 16

Adult Guardianship Program Trend 2008-2015 Individuals Served: End of Fiscal Year Guardianship Wards Case Count Comparison

• FY14 vs. FY15 +3% change • FY08 vs. FY15 +75% change • The case count changed by an average of +8% each year from 2008-2015.

Figure 4

424 489

532 583 605

682 720

743

0

100

200

300

400

500

600

700

800


Coun

t War

ds o

n Ju

ne 3

0

Wake County Adult Guardianship Wards End of FY 2008-2015

Source: Wake County Human Services Adult Guardianship Program


Page 17

Adult Protective Services (APS) Program Trend 2011-2015 Individuals Served: End of Fiscal Year Accepted Reports Case Count Comparison


Note: This program was added to the Human Services Board Quarterly Report in 2011.

Figure 5

247

267

238 234

266

200

210

220

230

240

250

260

270

280

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

Coun

t Rep

orts

Inve

stig

ated

in F

isca

l Yea

r

Wake County Adult Protective Services Accepted Reports End of FY 2011-2015

Source: Wake County Human Services Adult Protective Services Program


Page 18

Child Protective Services Child Protective Services (CPS) Accepted Assessments Trend 2008-2015 Families Served: End of Fiscal Year Accepted CPS Assessments Case Count Comparison


Figure 6

5,107 4,834 5,211 5,018

4,750

5,399 5,778

5,817

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


Coun

t Fam

ily A

sses

smen

ts &

Ass

ists

in F

isca

l Yea

r

Wake County Child Protective Services (CPS) Accepted Assessments End of FY 2008-2015

Source: Wake County Human Services Child Welfare


Page 19

Child Protective Services (CPS) New In Home Service Case Trend 2008-2015 Families Served: End of Fiscal Year New In Home Service Case Count Comparison

• FY14 vs. FY15 -4% change • FY08 vs. FY15 -13% change • The case count changed by an average of -1% each year from 2008-2015. New In

Home services cases that were opened increased annually from 2008 to 2011 then began to decrease.

Figure 7

738 817 810 844

729

582 664 639

0

100

200

300

400

500

600

700

800

900


Coun

t New

Fam

ily C

ases

Ope

ned

in F

isca

l Yea

r

Wake County Child Protective Services (CPS) New In Home Service Cases End of FY 2008-2015

Source: Wake County Human Services Child Welfare


Page 20

Foster Care Program Trend 2008-2015 Children Served: End of Fiscal Year New Children Entering Custody Case Count Comparison

• FY14 vs. FY15 +11% change • FY08 vs. FY15 +58% change • The case count changed by an average of +7% each year from 2008-2015. • Foster Care includes children in out of home placement and in legal custody of

Wake County. This graphic shows the number of new children coming into custody during a fiscal year. This group is a subset of the overall foster care case load.

Figure 8

232 240 264

319 333 307

331

367

0

50

100

150

200

250

300

350

400


Coun

t Chi

ldre

n En

terin

g Cu

stod

y in

Fis

cal Y

ear

Wake County Foster Care Entry End of FY 2008-2015

Source: Wake County Human Services Child Welfare Division


Page 21

Economic Services

Child Care Subsidy Program Trend 2008-2015 Children Served: End of Fiscal Year Open Case Count Comparison

• FY14 vs. FY15 -9% change • FY08 vs. FY15 -26% change • The case count changed by an average of -4% each year from 2008-2015. The

case count was stable from 2008-2010 and has decreased annually since 2012. All years are not comparable due to changes in eligibility criteria.

Figure 9

9,445 9,445 9,445 8,544 8,544

7,854 7,714 7,011

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000


Coun

t Chi

ldre

n Re

ceiv

ing

Subs

idy

Wake County Child Care Subsidy Case Count End of FY 2008-2015

Source: Wake County Human Services Child Care Subsidy Program


Page 22

Child Care Subsidy Wait List Trend 2008-2015 Children Served: End of Fiscal Year Wait List Count Comparison

• FY14 vs. FY15 +52% change • FY 08 vs. FY15 +6% change • The case count has a pattern of highs and lows from 2008-2012 and has a pattern

of annual increase since 2013. The wait list count at the end of the year for FY 2015 (3,806) is more similar to the figure for 2008 (3,580). Peaks and valleys in wait list counts from 2009-2012 are associated with available funding streams and changes in eligibility criteria.

Note: The figures in this graph shown case count numbers as reported at the end of each fiscal year

Figure 10

3,580

6,689

2,744

5,495 5,439

1,079

2,500

3,806

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000


Coun

t Chi

ldre

n on

Wai

t Lis

t

Wake County Human Services Child Care Subsidy Wait List End of FY 2008-2015

Source: Wake County Human Services Child Care Subsidy Program


Page 23

Family and Children’s Medicaid Program Trend 2008-2015 Individuals Served: End of Fiscal Year Open Case Count Comparison


Figure 11

36,558

41,495 45,317

47,870 51,751

53,209 57,438

59,221

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000


Coun

t Clie

nts o

n Ju

ne 3

0

Wake County Family & Children's Medicaid Program End of FY Case Count 2008-2015

Source: Wake County Human Services Family & Children's Medicaid Program


Page 24

Food and Nutrition Services (FNS) Program Trend 2008-2015 Households Served: End of Fiscal Year Open Case Count Comparison

• FY14 vs. FY15 +2% change • FY08 vs. FY15 +98% change • The case count changed by an average of +11% each year from 2008-2015. • In 2015, Wake FNS assisted an average of 2.4 persons per household served (in

2008, the average was 1.9 persons per household served)

Source: Duncan, D.F., Kum, H.C., Flair, K.A., Stewart, C.J., Vaughn, J., Bauer, R, and Reese, J. (2013). Management Assistance for Child Welfare, Work First, and Food & Nutrition Services in North Carolina (v3.1). Retrieved September 28, 2015, from University of North Carolina at Chapel Hill Jordan Institute for Families website. URL: http://ssw.unc.edu/ma/

Figure 12

19,866

25,892

30,408

35,809 39,063

35,818 38,585 39,371

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000


Coun

t Hou

seho

lds o

n Ju

ne 3

0

Wake County Food and Nutrition Services (FNS) End of FY 2008-2015

Source: Wake County Human Services Division of Social Services Economic Self Sufficiency

http://ssw.unc.edu/ma/


Page 25

Employment Services, Swinburne Center Trend 2008-2015 Individuals Served: End of Fiscal Year New and Repeat Customers Case Count Comparison

• FY14 vs. FY15 -11% change • FY08 vs. FY15 -3% change • The case count for new and repeat customers grew each year from 2008-2011, with

large amounts of growth starting during the economic downturn. The trend line shows peaks for 2012 and 2013 consistent with the expansion of services to the Millbrook Center. The trend line shows a sharp decline in 2014 consistent with the end of employment services at the Millbrook Center. This trend line is influenced by the availability of services, changes to the service model and the number of people seeking services.

*Millbrook Center numbers are included for 2012 and 2013 but services are no longer available at the site as of 2014.

Figure 13

20,416

25,998 27,816 28,166

38,828* 36,878*

22,326 19,790

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000


Coun

t New

& R

epea

t Cus

tom

ers

Employment Services Swinburne Center End of FY 2008-2015

Source: Wake County Human Services Employment Services Swinburne Center

*Millbrook Center


Page 26

Public Health and Clinics

Immunization Program Trend 2008-2015 Total People Served: Clients Receiving Vaccine Doses Administered by Wake County Human Services End of Fiscal Year Total Count Comparison • FY14 vs. FY15 -6% change in total served • FY08 vs. FY15 -36% change in total served • Regional Centers typically serve an average of 10% of all Immunization clients;

however, during the 2010 H1N1 outbreak, they served 25% (17,242) of the 69,115 clients served by the program.

Figure 14 Notes: *FY 2010 immunization numbers include H1N11 response (46,830 doses) and ARRA2 'Stimulus' Flu project (6,261 doses)

1H1N1- An influenza type A virus that is a respiratory infection and popularly named “swine flu.” The virus was first recognized in April 2009 and spread quickly to 74 countries worldwide.

2ARRA-American Recovery and Reinvestment Act of 2009.

24,961 26,393

69,115*

21,824 19,295 22,190

16,973 15,988

2,506 2,716

17,242*

2,311 2,158 2,683 1,771 1,794 0

10,000

20,000

30,000

40,000

50,000

60,000

70,000


Coun

t Clie

nts S

erve

d

Wake County Immunization Program, Total Clients Receiving Vaccine Doses Administered by WCHS End of FY 2008-2015

Total Clients at WCHS Receiving Vaccine Doses in FYTotal Clients Receiving Vaccine Doses at a Regional Center in FY

*FY 2010 numbers include H1N1 response and ARRA 'Stimulus' Flu project

Source: Wake County Public Health, Immunization Program, July 24, 2015


Page 27

Women, Infants and Children (WIC) Program Trend 2008-2015 Individuals Served: End of Fiscal Year Open Case Count Comparison

• FY14 vs. FY15 -3% change • FY08 vs. FY15 -6% change • This case count grew each year from 2008-2010. The end of year case count figure

is smaller than the previous year since 2013.

Figure 15

18,048

18,371

18,968

18,213 18,193 18,242

17,428

16,891

15,500

16,000

16,500

17,000

17,500

18,000

18,500

19,000

19,500


Coun

t Act

ive

Part

icip

ants

on

June

30

Wake County WIC Program End of Year Case Count End of FY 2008-2015

Source: Wake County Women, Infants and Children's Program, August 5, 2015

Issue of concern-- Wake County WIC program points to multiple factors influencing decreased usage of Wake WIC services in 2015 including: delays in processing Medicaid & Food Stamp Applications; possible decline in birth rates; staffing vacancies; 25% reduction in appointments; 23 days of Staff training for new management data system and 25 days of business closing during fiscal year 2015.


Page 28

Clinical, Family Planning Program Trend 2008-2015 Individuals Served: End of Fiscal Year Open Case Count Comparison

• FY14 vs. FY15 -6% change • FY08 vs. FY15 -28% change • This trend line has gradually decreased every year since 2008. From 2008-2012 the

amount of decrease in case count from year to year ranged from -4% to -1%. The case count started decreasing at a faster pace after 2012:

o FY12 vs. FY13 -5% change o FY13 vs. FY14 -9% change o FY14 vs. FY15 -6% change

• Fertility rates have been identified as a horizon issue.

Figure 16

10,202 9,869 9,474 9,171 9,078 8,644 7,885

7,394

0

2,000

4,000

6,000

8,000

10,000

12,000


Tota

l Ser

ved

in F

isca

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Wake County Human Services Clinical - Family Planning End of FY 2008-2015

Source: Wake County Human Services Women's Health Clinic Program


Page 29

Vital Records Processed Births and Deaths Trend 2008-2015 Records Processed: End of Calendar Year Case Count Comparison

Birth Records Processed • CY13 vs. CY14 -.18% change • CY08 vs. CY14 -11.6% change • The number of birth records has dropped every year since 2008. The largest year to

year decreases are seen for CY08 to CY09 (-5%) and CY09 to CY10 (-5%). The rate of decrease began to slow down after CY11. The most recent reporting period shows a decrease of -.18% from CY13 to CY14.

• United States birth rates tend to decrease during periods of recession and tend to rebound during post-recession recovery. In December 2014, a Carolina Demography at UNC’s Carolina Population Center blog reported “NC Births are not rebounding to 2007 levels.” Source: Tippett, Rebecca. 2014. “NC Birth Trends in 5 Graphs.” Blog. Carolina Demography. http://demography.cpc.unc.edu/2014/12/08/nc-birth-trends-in-5-graphs/.

Death Records Processed • CY13 vs. CY14 +4.2% change • CY08 vs. CY14 +22.9% change

Figure 17

14,814 14,130

13,417 13,208 13,047 13,117 13,093

4,636 4,640 4,729 4,989 5,256 5,464 5,698

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

CY 2008 CY 2009 CY 2010 CY 2011 CY 2012 CY 2013 CY 2014

Coun

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ords

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cess

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Wake County Human Services Vital Records, Birth and Death Records Processed by Calendar Year (CY) 2008-2015

Vital Records - Births Vital Records - Deaths

Source: Wake County Register of Deeds, Wake County Human Services Vital Records, July 24, 2015

http://demography.cpc.unc.edu/2014/12/08/nc-birth-trends-in-5-graphs/

http://demography.cpc.unc.edu/2014/12/08/nc-birth-trends-in-5-graphs/


Page 30

Sexually Transmitted Infections, Syphilis and HIV Trend 2008-2014 Count Diagnosis: Wake County Individuals with diagnosis in a Calendar Year (CY)

Individuals with a diagnosis in Wake County require varying levels of service; at minimum staff must enter information in the North Carolina Disease Surveillance System (NCEDDS).

Syphilis Case Count • CY13 vs. CY14 +61% change • CY08 vs. CY14 +362% change • This case count trend shows an increase of 211% from 2008 to 2009, a three year

pattern of decrease is seen 2010, 2011 and 2012; and an increase is seen starting in 2013 and continuing into 2014.

HIV/AIDS Case Count • CY13 vs. CY14 +30% change • CY08 vs. CY14 -23% change • This case count trend decreased from 2008 to 2013 and an increase is seen when

comparing CY13 to CY14.

Figure 18

CY 2008 CY 2009 CY 2010 CY 2011 CY 2012 CY 2013 CY 2014Syphilis Services 37 115 84 76 75 106 171HIV / AIDS Services 321 281 285 249 197 190 247

37

115 84 76 75

106

171

321

281 285

249

197 190

247

0

50

100

150

200

250

300

350

Coun

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New Cases of Syphilis and HIV/AIDS in Wake County by Calendar Year (CY) 2008-2014

Source: North Carolina Electronic Disease Surveillance System (NCEDSS), retrieved by Ramsay Hoke, WCHS Epidemiology Program


Page 31

Sexually Transmitted Infections, Gonorrhea and Chlamydia Trend 2008-2014 Count Diagnosis: Wake County Individuals with diagnosis in a Calendar Year (CY)

Individuals with a diagnosis in Wake County require varying levels of service; at minimum staff must enter information in the North Carolina Disease Surveillance System (NCEDSS).

Gonorrhea Case Count • CY13 vs. CY14 -4% change • CY08 vs. CY14 +12% change • This case count increased CY09 to CY11, growth started to slow down in CY12 and

the trend shows a pattern of yearly decrease since 2012. Chlamydia Case Count • CY13 vs. CY14 +3.4% change • CY08 vs. CY14 +39.4% change • This case count increased every year from 2008-2012; it decreased from CY12 to

CY13 and increased from CY13 to CY14.

Figure 19

CY 2008 CY 2009 CY 2010 CY 2011 CY 2012 CY 2013 CY 2014Gonorrhea

Services 1,030 1,010 1,249 1,355 1,381 1,205 1,157

ChlamydiaServices 3,121 3,590 4,530 4,748 4,757 4,210 4,352

1,030 1,010 1,249 1,355 1,381 1,205 1,157

3,121 3,590

4,530 4,748 4,757 4,210 4,352

0500

1,0001,5002,0002,5003,0003,5004,0004,5005,000

Coun

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New Cases of Gonorrhea and Chlamydia in Wake County by Calendar Year (CY) 2008-2014

Source: North Carolina Electronic Disease Surveillance System (NCEDSS), retrieved by Ramsay Hoke, WCHS Epidemiology Program


Page 32

Wake Coordinated Transportation Services (WCTS) Transportation Services Trend 2011-2015

Individuals Served: End of Fiscal Year Total Services and Trips Provided Case Count Comparison

Total Services include trips (ridership) provided, bus passes, gas cards and assistance with transportation through WCTS/TRACS. Trips are the most commonly provided service; each trip is counted as a one-way event.

Total Services Count • CY14 vs. FY15 +26% change • CY11 vs. FY14 +59% change • In 2011 trips were 96% of all services, in 2015 trips were 81% of services (with

passes and gas cards assistance accounting for the remainder) Trips Provided Count • CY14 vs. FY15 +28% change • CY11 vs. FY14 +28% change • Ridership has increased for the most part, sharp changes in ridership is most often

associated with severe weather and changes in funding.

Figure 20

139,317

107,382

141,158 138,912

178,407 144,838

116,082

167,754 175,516

221,394

0

50,000

100,000

150,000

200,000

250,000

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015

Coun

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Wake Coordinated Transportation Services (WCTS) 5-Year Ridership End of FY 2011-2015

Trips Provided Total Services (trips, bus passes and gas cards)

Source: Wake County Human Services Transportation Program


Page 33

Customer Support Call Center Monthly Activity Trend FY 2015 Calls Managed: End of Fiscal Year Count of Calls Managed A new Customer Support Call Center was put in place late in FY 2014. This report is a summary of highlights from the first full fiscal year of activity. A month to month review of FY 2015 shows:

• 569,889 Total Calls managed by the Call Center in fiscal year 2015 • 74,457 Call backs completed using a feature that allows a caller to enter a call-back

number for an agent to return the call to a specific number, decreasing hold times


Page 34

WCHS End of Year Case Count Updates for Fiscal Year 2008-2015 and Calendar Year 2008-2014