Jefferson County Public Health
2014 ANNUAL REPORT
Covered? We’ve got you covered. Jefferson County Public Health
Letter from the Executive Director Last year was a big year for public health, not only in Jefferson County, Colorado, but across the United States. In 2014, Jefferson County Public Health (JCPH) took action on a wide range of health threats, including monitoring travelers from Ebola affected countries in West Africa in response to the largest outbreak in history; fighting heart disease, the County’s leading cause of death, by educating about the leading risk factors, tobacco use, physical inactivity, unhealthy diet and inability to access quality healthcare; improving the condition and security of our food and drinking water resources; and, protecting our communities from animal-borne diseases. Additionally, our public health clinics continued to educate and provide services to prevent unintended pregnancies, sexually transmitted infections as well as immunizations to protect against vaccine preventable diseases. We also took action moving forward with our community health improvement plan (CHIP) by building and strengthening partnerships and developing shared strategies for creating conditions in which everyone in our County can be healthier through better access to healthy foods and active living. Last year was also the year the Affordable Care Act’s major provisions went into effect and in Colorado alone, according to Connect for Health Colorado, over 150,000 people acquired health insurance for the first time. JCPH continues to help people with accessing health insurance and now accepts many forms of health insurance in our preventive health clinics. In addition, we completed the move of most of our programs and services to our new location at 645 Parfet St. in Lakewood, and rewrote our mission and vision statements to more accurately reflect the work we do:
Mission: “To promote and protect health across the lifespan through prevention, education, and partnerships.” Vision: Healthy People, Healthy Places” With all of these changes and improvements, we want everyone to know, that when it comes to public health services, JCPH HAS YOU COVERED. Whether it’s a kit to test for radon gas in your home, a home visit from a public health nurse, help with enrollment in the Women, Infants and Children (WIC) Program, birth control resources, immunizations, planning for emergencies, support for municipalities to become more walkable and bikeable, creating more community gardens, encouraging mass transit, or getting a birth or death certificate, We’ve got you covered! Public health is the foundation of our nation’s health system, and as the Institue of Medicine said in 1988, “Public Health is what we as a society do collectively through organized actions to assure the conditions in which all people can be healthy!” JCPH will continue to work to improve the quality of life and health of our individuals, communities, and health systems, both in our natural and built environments. Please visit our web site at jeffco.us/public-health to learn more about JCPH and the services we provide to keep you covered across the lifespan.
Healthy People Healthy Places
Mark B. Johnson, MD, MPH Executive Director, Jefferson County Public Health
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Creating a Culture of Health and Wellness through Policy and Partnerships Achieving healthier neighborhoods, businesses, communities and institutions is at the core of Jefferson County Public Health’s new vision, mission and the community health improvement plan (CHIP) entitled, “Healthy People Healthy Places Jefferson County.” Broader partnerships and innovative strategies are resulting in healthier places where people live, work, learn, play and age. In the past two decades, there has been a stronger focus on the role of the built environment and health, particularly the built environment’s role in fostering sedentary lifestyles and ultimately chronic disease. In Jefferson County, we are experiencing increased rates of obesity, diabetes and hypertension. As a result, public health and its partners are examining how built environments can be transformed to increase opportunities for daily physical activity and access to healthy, fresh and affordable food regardless of age, income, ethnicity and gender. Land use planners, transportation specialists, parks, recreation, and open space staff, educators, health care, mental health, public health, local government, business and economic development, elected officials and many more disciplines are working together to plan, budget and maintain communities that ensure access to public transportation, playgrounds, parks, trails and recreation centers, safe and walkable neighborhoods, community gardens, farmers’ markets and places to meet, gather and celebrate. We know that the health benefits of welldesigned places have cross-cutting benefits for communities. These places are proving to be safer, more attractive to live and, foster a sense of place and community and help older adults age in place. Jefferson County Public Health received a Cancer, Cardiovascular Disease, and Pulmonary Disease Prevention (CCPD) grant from the Colorado Department of Public Health and Environment to support various built environment improvements, its CHIP and to implement the new program, “Creating a Culture of Health and Wellness in Jefferson County Through Policy.” Supported by the Jefferson County Healthy Eating Active Living (HEAL) policy team, staff will work to provide technical assistance to local partners on a variety of land use, transportation and food policy areas. Some exciting and innovative 2014 partner accomplishments include: • Arvada, Edgewater, Golden, Lakewood and Wheat Ridge joined the HEAL Cities & Towns Campaign (livewellcolorado.org/healthypolicy/heal-cities-and-towns) by adopting resolutions committing their jurisdictions to support healthy eating and active living policies, environments, and programs. A partnership between LiveWell Colorado and the Colorado Municipal League, the HEAL Cities & Towns Campaign provides training and technical assistance to help municipal officials adopt policies that improve access to physical activity and healthy food in their communities. All the participating municipalities in Colorado met for a two-day summit in Golden during October 2014 to share practices and lessons learned with national and local partners. • Jeffco Public Schools received a Colorado Department of Transportation Safe Routes to Schools Grant to educate and build awareness on safe cycling among youth. In addition, countless Jefferson County individuals, families, schools and local governments implemented safe and fun community building activities like Walking School Buses, walking or bike audits, or
Healthy People Healthy Places
community walking groups to support a culture of physical activity. • The City of Arvada “Healthy Places Arvada” (healthyplacesarvada. org) is one of three Colorado communities that received the Colorado Health Foundation Healthy Places Initiative funding to improve access and connectivity to open space and neighborhoods, making it easier to walk, bike, play and engage in daily activities that encourage movement and connection with the community.
“These places are proving to be safer, more attractive to live and, foster a sense of place and community...” • Bike Colorado (bicyclecolorado.org), Bike Jeffco (bikejeffco.org) and municipalities in Jefferson County, continually address inter and multi-jurisdictional approaches to build and maintain bike facilities to support active transportation options in Jefferson County. Grassroots networks like the Wheat Ridge Active Transportation Advisory Team are working to educate and engage policy makers on the importance of funding new bike improvements in neighborhoods. • The Cities of Arvada, Golden and Lakewood have or will update their comprehensive, recreation, parks or sustainability plans to incorporate public health policies, practices and programs. • Jefferson County Open Space (JCOS) updated their Open Space Master Plan (jeffco.us/open-space/plans/open-space-masterplan). This new plan includes numerous references to public health, and the important role of green space in supporting wellbeing. JCOS also supports the Jeffco Outdoors program (www.jeffcooutdoors.org) connecting people with the outdoors to create healthier individuals and families. • Employers and health care facilities in Jefferson County are exploring new and exciting ways to integrate physical activity into employees’ daily lives like physical activity breaks, walking meetings and encouraging the use of stairs. • Multiple Jefferson County municipalities, CSU Extension Jefferson County (www.extension.colostate.edu/jefferson) and partners like Denver Urban Gardens (dug.org) are increasing the number of community and school gardens, and community supported agriculture opportunities to increase residents’ opportunity to grow and source healthy, affordable local produce. • The Denver Regional Council of Governments (DRCOG) Sustainable Communities Initiative (www.drcog.org/planning-great-region/ sustainable-communities-initiative) is working to align planning, investments, programs and policies to support mixed-used, pedestrian and bicycle-friendly and transit oriented development to maximize the use of transit, including the forthcoming FasTracks Gold Line (www.rtd-fastracks.com/gl_1) For more information on ways to support changes to the built environment to foster healthier lifestyles, contact Molly Hanson mhanson@jeffco.us or Max Gibson maxgib@gmail.com.
Public Health Transportation
Mission: To promote and protect health across the lif
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2014 In Review As we look into the future and plan for a healthier Jefferson County with better access for all to healthy eating, physical activity and health care, we would also like to review some of Jefferson County Public Health’s accomplishments in 2014.
Tobacco Policies Work to Protect Health for All
For most of us, consistently making healthy choices is not easy. A major role of public health is to help individuals, families and communities make the healthier choices the easier ones to make. Whether it is improving nutrition, getting more physical activity, or living tobacco-free, there are proven strategies to support people in making the choice for health the easier and more natural option. For example, if there’s a safe and accessible walking or biking trail near your work or home, it’s easier to get out for a walk or bike ride. If you have affordable, nutritious food available and accessible, it’s easier to pass up the less healthy options. And, if you live or work in a place where tobacco use is restricted, it’s easier for youth and adults to live tobacco-free. Community-level policies which assure healthier resources and protections are helping people across the nation slow and even reverse some of the most debilitating disease trends - like diabetes, heart disease and lung cancer. One of the most well-researched areas of the power of policy change is tobacco control and smoke-free public places laws. Communities with more comprehensive smokefree workplace and public places laws see the greatest benefits when it comes to youth tobacco prevention and reducing adult use of tobacco. In addition to protecting workers and residents from the toxic chemicals in secondhand smoke and e-cigarette aerosol, comprehensive smoke and vapor-free policies make it easier for youth to say no to the use of tobacco and make it easier for adults who use to cut back and quit. In Jefferson County in 2014, the communities of Edgewater, Lakewood and Golden strengthened their smoke-free public places laws to cover more areas and/or include prohibiting the use of electronic smoking devices where smoking is prohibited. Thanks to policy changes, making the healthier choice just got a little easier for many in Jefferson County. For more information, contact Donna Viverette at 303-275-7555 or email dviveret@jeffco.us.
Improving Water Quality . . . New Septic Regulations
The year 2014 saw the most significant modifications in the onsite wastewater treatment (septic) system regulation in several decades. Based on changes in state law and regulations – in which Jefferson County Public Health was an active participant – significant new requirements governing the design, installation, operation and use of these systems were adopted. Drainfield A broad-based stakeholder process Soil preceded the adoption of the new Pipe regulations, allowing for community input and addressing local concerns to the extent possible. New and more rigorous requirements for soil Soil testing and design standards mean that Groundwater systems will be better suited to actual site conditions, thus providing improved treatment and groundwater protection. Additional oversight of mechanical, “higher level treatment” systems will assure that these complex wastewater treatment units are properly maintained and that the homeowner is more fully involved in the process. In addition, the Department made significant progress towards an online the oil and
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application platform for wastewater permits that will provide faster, more efficient services for our clients. Stay tuned for even more progress in 2015! For more information, contact Craig Sanders, EHS Supervisor at 303-271-5759
Mental Health Matters . . .
Increasing Awareness and Treatment of Perinatal Depression and Anxiety JCPH’s maternal and child health programs work to maximize the quality of life and health of mothers, infants, children and their families in Jefferson County. Our public health nurses work in partnership with caregivers to assist them in setting goals that improve the lives of their families. We know that depression and poor mental health among childbearing women and caregivers can have devastating effects on families and communities. We see and understand how stress and other mental health issues (big and small) can impact perinatal health and are working to improve birth outcomes and promote healthy growth and development for all of our families through education and awareness. It is estimated that nearly 20% of mothers experience depression, anxiety or other mental health issues before, during or after giving birth. These perinatal conditions are fairly common and yet they often go unrecognized and untreated, leaving mothers and children at risk. Depression and anxiety, especially during the postpartum period, is known to affect moms’ ability to care for the infant and other children, decrease infant bonding and have lifelong negative impacts on a child’s growth and development. In 2014, JCPH expanded its resources to address caregiver mental health and perinatal mood and anxiety disorders (PMADS) though a Pregnancy-Related Depression grant from the Community First Foundation. The grant allows public health nurses to work in the community and with individuals to increase awareness of perinatal mood and anxiety disorders, including the negative health effects of toxic stress, and provide mental health support and community resources. Throughout the first year of the Program’s implementation in 2014, JCPH provided extensive outreach to medical providers and community organizations on the prevalence of PMADs and best-practice screening and treatment options. In its second year, we look forward to continuing work in the community in addition to providing increased support for our staff and clients by employing a mental health specialist at JCPH. For more information, contact Sara Bauer, RN, MN, MA, Public Health Nursing Manager at 303-275-7582.
Introducing the Foothills Healthcare Coalition . . . Preparing Gilpin, Clear Creek and Jefferson Counties Responding to public health emergencies is made that much easier when all the different players have planned and prepared and planned again. The Foothills Healthcare Coalition was convened in 2014 to better prepare the public health and healthcare systems of the Colorado counties of Clear Creek, Gilpin and Jefferson to respond to emergencies. On the heels of various public health threats and emergencies, including wildfires, floods and disease outbreaks, JCPH’s Emergency Preparedness Program brainstormed with other emergency response agencies in the County to develop a volunteer healthcare coalition. The Foothills Healthcare Coalition’s mission is to collaborate on planning which will enhance and sustain the ability and capacity of the public health and health care systems, community partners, and individuals in the three counties to prevent, protect against, quickly respond to, and recover from all-hazard emergencies, particularly those whose scale, timing, or unpredictability threatens to overwhelm routine activities. In 2014, the Foothills Healthcare Coalition brought together over 90 members from over 50 agencies for public health and health care emergency preparedness planning. The coalition hosted four meetings that addressed a variety of topics, from the Ebola outbreak to pandemic preparedness to emergency operations coordination. For more information, or to get involved contact Christine Billings, Emergency Preparedness Supervisor at 303-271-8394 or visit the Coalition’s website at: foothillshealthcarecoalition.com.
fespan through prevention, education, and partnerships.
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2014 Achievements and Health Outcomes
Jefferson County Public Health is committed to promoting health and preventing injury and disease for all of the residents of Jefferson County, Colorado. Public health is what we as a society do collectively to prevent illness and premature death and promote health in our neighborhoods and communities. Public health professionals monitor, identify, diagnose, investigate and solve public health problems in communities and promote policies, practices and behaviors to assure our populations stay healthy. It is the collaborations and efforts of all of us that ultimately determine the County’s health. With the support, policy oversight and mandates of the Jefferson County Board of Health, our programs work to prevent and control contagious diseases and epidemics; investigate health and safety hazards; protect our environment; prevent foodborne illness; link people to health care services; promote active living and healthy eating; and, advocate and enforce laws that protect the health and safety of everyone. Administrative Services (Admin) provides department administration and financial management as well as the Emergency Preparedness and Response Program and Vital Records, Epidemiology and Health Planning. • 6,008 birth and 4,971 death certificates (first copy) were issued providing residents with essential identification documents as well as providing a snapshot of the number and causes of death in the county throughout the year. •
JCPH Emergency Preparedness and Response Program updated or wrote 12 plans; provided county wide support for Ebola Preparedness and Response activities within the County; represented JCPH on 2 national planning committees; participated in 3 national trainings; participated in 5 statewide trainings; provided 9 countywide emergency related trainings; partnered with Jeffco schools to provide disease control guidance and coordinated the response to 45 disease outbreaks.
Environmental Health Services (EHS) works to prevent, investigate and respond to health threats in the County from environmental sources such as our air, water, land, the food we eat and the domestic and wild animals and insects we encounter. EHS inspects facilities including schools, daycares and restaurants for adherence to public health safety and disease control measures. • 3,647 food-service establishment inspections were performed and 116 food handlers were educated to protect people from common foodborne illnesses such as E. coli, Salmonella and hepatitis A. The JCPH Retail Food Inspection web page was visited 59,428 times by persons seeking information on food-safety records of various eateries. • 231 land development and rezoning cases were reviewed for compliance with public health requirements. • 587 inspections of childcare centers, pools and camps were performed protecting children and adults from disease and safety hazards. • 563 onsite wastewater system inspections were performed and 212 permits were issued to protect residents from waterborne illnesses and protect the county’s groundwater from contaminants. • 853 time-of-sale wastewater permits were approved and onsite wastewater permit records for nearly 1,400 additional properties were added to the septic system computer database, providing easier and much more efficient access for public queries. • The Zoonosis (animal-borne disease) Program investigated potential disease threats such as hantavirus pulmonary syndrome, bubonic plague, tularemia, West Nile virus, and rabies, submitting 173 animal specimens for testing resulting in 11 bats testing positive for rabies, 2 squirrels and 1 rabbit testing positive for tularemia, and 1 prairie dog testing positive for bubonic plague. The Department also tracked 36 cases of humans bitten by domestic animals, • 317 inspections were conducted of a variety of air pollution emission sources throughout the County.
Health Promotion and Lifestyle Management (HPLM) works to improve health through policies,
programs and activities enabling people to increase control over their health. Policies, programs and services promote healthy eating and active living, tobacco free environments and access to health communications and public information. Policy work involves working with elected officials and our communities to adopt policies that promote healthy eating, tobacco free public places and built environments that support safe walking, biking and multimodal transportation. • 10,106 women and children were provided with nutrition education and counseling and food prescription vouchers to be used for healthy foods at local grocery stores. • Our web site had 141,686 views and 5,422 people followed our social media pages, for diverse public information and health education materials. A monthly newsletter reached 2,010 individuals and 51 news releases sent out to media and media • Tobacco control activities to reduce initiation and use of tobacco continued in 2014. More than 5,246 youth and young adults ages 14 – 24 participated in activities to raise awareness about tobacco and impact local policies proven to reduce tobacco use and exposure. Another 548 youth and young adults and 6,010 adults participated in or were referred to services to help them quit. Local media and public information activities focusing on protecting youth from tobacco and secondhand smoke exposure reached more than 678,432 people. Our goal is to reduce youth and young adult tobacco use and initiation by 50% by 2020. 528 providers of education, mental health, housing and health care services were trained in approaches to address tobacco with patients and clients.
Jefferson County Board of Health Bonnie McNulty - President Maureen Sullivan - Vice President Beverley Dahan - Secretary Greg Deranleau - Member Linda Reiner - Member
Community Health Services (CHS) programs and services work to improve health and quality of life through communicable disease surveillance, prevention, control, education and treatment. Diverse programs provide essential preventive health screenings, health education, and public health nursing interventions, resource referral as well as access to health care for the County’s uninsured or underinsured residents. • 5,201 immunizations were given protecting the County’s children and adults from vaccine preventable diseases. • 2,488 disease surveillance contacts were made to investigate and follow-up in response to potential communicable disease threats. • 3,822 nurse home visitations were made to improve health outcomes for infants and mothers. • 6,697 enrolled in Medicaid and CHP+ received follow-up in the Healthy Communities Program to assure that they accessed health care benefits and community resources; 1,680 were assisted with referrals to community health care resources. • 7,235 clinic visits (4,400 family planning, STI, HIV visits and 2,835 immunization visits) were made by individuals seeking dental, reproductive health and chronic disease prevention screenings and consultation.
JCPH Budget 2014 Total 2014 Revenue = $13,138,302 HPLM 20%
EHS 8%
ADMIN 51%
CHS 21%
Jefferson County Board of Commissioners
Casey Tighe - Chair, District 2 Libby Szabo – Chair Pro Tem District 1 Donald Rosier – District 3
Total 2014 Expenditures = $13,138,302 HPLM 21%
Jefferson County Public Health
EHS 16% CHS 35%
Mission: To promote and protect health across the lifespan through prevention, education and partnerships.
ADMIN 28%
jeffco.us/public-health
Where to Find Us: Clinics, WIC, Tobacco, Health Communications: 645 Parfet Street, Lakewood CO 80215
303-232-6301
Administration, Health Promotion & Environmental Health Offices: 645 Parfet Street, Lakewood CO 80215
303-232-6301
Arvada WIC: 6303 Wadsworth Bypass, Arvada, CO 80003
303-275-7500
Edgewater WIC: 1711 A & B Sheridan Blvd., Edgewater, CO 80214
303-239-9580
Vital Records: 800 Jefferson County Parkway, Suite 1300, Golden, CO 80401
303-271-6450
Emergency Preparedness: 800 Jefferson County Parkway, Golden, CO 80401
303-271-8391