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Annual Report

MADISON COUNTY Department of Health


Our Mission We, the Madison County Department of Health, promote and protect the health of our community through assessment, education, and by ensuring necessary services. Working within a network of partners, we strive to meet the health needs of Madison County.


From our Board President cancer, diabetes, arthritis, obesity, respiratory diseases, and oral conditions) are the leading causes of death and disability.

The Madison County Board of Health is

honored to serve the citizens of Madison County. We continue to strive to fulfill our mission to guide, advocate, and collaborate to ensure the essential public health services are provided to residents of Madison County.

7 out of 10 deaths each year are from chronic diseases. Heart disease, cancer and stroke account for more than 50% of all deaths each year.

The Board was actively involved with the 2013 Community Health Assessment and Community Health Improvement Plan. A life stage format was selected for the assessment and improvement plan. This allowed the strategic health directives of healthy care, healthy behavior and healthy environment to be applied throughout life, from infants to older adults.

In 2005, almost 1 out of every 2 adults had at least one chronic illness. Obesity has become a major health concern. 65% of adults are overweight, with 1 in every 3 adults being obese, and almost 1 in 5 youth between the ages of 6 and 19 are obese. Diabetes in 30-year-olds has increased 70% in the last 10 years.

In an effort to discuss local public health topics in different regions of the county, the Board has traveled to various communities across the county for its meetings. This has given us the opportunity to improve communication and collaboration with local community leaders and organizations.

This may be the first generation in which children lead a shorter life span than their parents. More than 75% of our health care spending is on people with chronic conditions.

It is clear that preventative medicine is essential to address the public health needs for the residents of Madison County. The goal of preventative medicine is to promote and protect health in order to prevent disease and death, rather than ignoring health until a disease is present and then treating symptoms or attempting to cure. The cost of health care is rising. More tax dollars are going towards payment of health care services. The health care insurance and the delivery of health care services landscape are changing, and it may or may not be for the better.

Mental illnesses and chronic diseases are closely related. Chronic diseases can exacerbate symptoms of depression, and depressive disorders can themselves lead to chronic diseases. Loneliness, depression and isolation have been shown to increase the risk of illness and premature death. Nonetheless, it is estimated that for 95% of people, the most common diseases related to cardiovascular disease, diabetes and hypertension are preventable. This can be achieved just by changing diet and choosing to live a healthy lifestyle. These changes are

Consider the following: Chronic diseases (heart disease and stroke,

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a way to regain control of your health, choosing to prevent and even to help treat disease. Everyone has to take responsibility for their health. General healthy lifestyle choices by individuals will have profound beneficial effects on the collective health of our communities.

design, healthy housing and a healthy environment. We need to take control of our health care by becoming actively involved with our health. What is one easy thing you can do today to live healthier? Thank you for wanting to be a part of a healthier Madison County.

The goal of making healthy lifestyle choices is living better, with less disease and disability. There can be some dramatic and powerful changes by making healthy lifestyle choices, without waiting long to see some of the benefits. Not only can disease be prevented, but some disease can be reversed. Research has revealed that even a measurable increase in brain size can occur. These choices are low technology and low cost. Healthy lifestyle choices include eating healthier (low fat, whole food and plant-based diet), incorporating a routine of moderate exercise, smoking prevention and cessation, having support groups and community, and managing stress.

Dr. John B. Endres President, Board of Health

The greater the degree of movement in a healthy direction, the longer people live, the better people feel, the healthier people’s weight will be, and the less chronic disease people will have. As we know, once disease is present, the more severe lifestyle changes need to be. We cannot address the escalating health care costs without addressing the problem of chronic diseases. If a collective community effort of healthy lifestyle changes could be accomplished, a large amount of health care resources could be freed up and directed towards disease treatment and other health care needs. We need to develop a health care system, not a sick care system. To promote health and prescribe solutions to improve health, not just to manage disease. We need public policies that promote healthy community

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From the Director HRSA and funds received from the Health Foundation for Western and Central New York. The formation of the MCRHC is the culmination of the strategic initiative identified in our 2009 County Health Improvement Plan.

The year 2013 presented new opportunities

and exciting challenges for public health in Madison County. New York State made changes in the New York State Public Health Law that affects the programs and services provided through the county health department as well as the state aid received for these services.

Madison County was recognized by the New York State Department of State for efficient government and received a Local Government Performance Efficiency Program award of $1.6 million for the privatization of the home care nursing services, thereby ensuring the provision of needed health care services while saving taxpayer dollars.

The flooding event at the end of June altered the lives of hundreds of our residents and employees. The flooding left devastation that would require an immediate and focused response from our department. I am so proud of the amazing work that was done during and following the flood by the incredible staff of MCDOH. Several of our own employees suffered damage to their property, yet came to work to help their fellow residents. It’s a reflection of, not only the dedication of our employees, but of what makes Madison County a great place to live. With the arrival of the flood, MCDOH nurses provided tetanus shots and health information to our residents and responders. Our Environmental Health Division assured the safety of our water supply, addressed health issues related to sewage and water treatment system failures, provided education on dealing with mold and mosquitoes, and performed heightened inspections of food service establishments affected by the flood.

At a national level, the third publication of the National County Health Department Ranking report showed that Madison County continued its ranking among the top New York Counties by ranking 14th in overall health outcomes and 14th in overall health factors (out of 62 counties including NYC). A big thank you goes to the public health employees who continually strive to provide compassionate, quality service to our community, and to our county leaders for their strong support, as we work collaboratively to ensure the conditions in which our families can be healthy.

In 2013, the MCDOH launched a comprehensive community health assessment project to identify and prioritize the health needs of Madison County. Through a strong collaborative effort among community-based agencies, we are better positioned to address the health issues challenging Madison County. A summary of the priority health issues is provided in this report.

To your health,

Eric Faisst

In April 2013, the Madison County Rural Health Council, Inc. (MCRHC), a non-profit rural health network comprised of local and regional health care providers, was officially established through federal funds received from

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Public health encompasses three core functions: assessment of information on the health of the community, comprehensive public health policy development and advocacy for best management practices, and assurance that public health services are provided to the community. These functions have been defined further and expanded into 10 essential public health services.

Monitor health status to identify and solve community health problems.

Diagnose and investigate health problems and health hazards in the community.

Inform, educate, and empower people about health issues.

Mobilize community partnerships and action to identify and solve health problems.

Develop policies and plans that support individual and community health efforts.

Enforce laws and regulations that protect health and ensure safety.

Link people to needed personal health services and assure the provision of health care when otherwise unavailable.

Assure a competent public and personal healthcare workforce.

Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

Research for new insights and innovative solutions to health problems.

Effectively provided, these services will reduce the substantial burden of preventable illness and injury. Further, costly medical services needed to treat preventable conditions are avoided. Prevention is not only cost-effective; it is fundamental to assuring quality of life for all Madison County residents. While no definition of public health’s essential role in our county’s health system will ever be final, this statement of essential services is used as a tool for moving forward with greater clarity of purpose in a time of challenging changes.

of Medicine, Committee for the Study of the Future of Public Health. The Future of Public Health. Washington, DC: National Academy Press, 1988.

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Harrell, J.A., and Baker, E.L. The essential services of public health. Leadership in Public Health 3(3):2731, 1994.

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State of Health in Madison County Madison County 2011

2011 Rank

Madison County 2012

2012 Rank

Madison County

2013

New York

Top U.S.

2013

Rank

2013

Performers*

5,650

5,317

HEALTH OUTCOMES

16

10

14

Length of Life

12

11

11

Premature death

5,431

Quality of Life

5,250 26

5,250 15

18

Poor or fair health

13%

14%

15%

15%

10%

Poor physical health days

3.4

3.3

3.2

3.5

2.5

Poor mental health days

3.4

3.0

3.7

3.4

2.4

7.3%

6.7%

6.7%

8.2%

6.0%

Low birth weight HEALTH FACTORS

20

15

14

Health Behaviors

35

21

19

Adult smoking

26%

23%

22%

17%

14%

Adult obesity

27%

27%

27%

24%

25%

Food Environment Index

--

--

8.9

8.3

8.7

Physical inactivity

--

--

24%

24%

21%

Access to exercise opportunities

--

--

48%

89%

85%

14%

23%

15%

17%

10%

Alcohol-impaired driving deaths

--

--

7%

24%

14%

Sexually transmitted infections

162

166

179

528

123

Teen birth rate

19

17

17

24

20

Excessive drinking

Clinical Care

19

22

13

Uninsured

17%

11%

10%

13%

11%

Primary care physicians

865:1

1,749:1

1,667:1

1,216:1

1,051:1

Dentists

--

3,023:1

3,350:1

1,362:1

1,439:1

Mental health providers

--

--

886:1

525:1

536:1

Preventable hospital stays

74

72

63

65

46

Diabetic screening

82%

85%

85%

85%

90%

Mammography screening

70%

76%

74%

63%

71%

Social & Economic Factors

15

12

18

High school graduation

85%

85%

84%

77%

--

Some college

59%

59%

61%

65%

70%

Unemployment

8.0%

8.1%

8.7%

8.5%

4.4%

Children in poverty

17%

18%

18%

23%

13%

Inadequate social support

19%

19%

19%

24%

14%

Children in single-parent homes

30%

32%

31%

35%

20%

Violent crime rate

89

81

75

392

64

Injury deaths

--

--

49

40

49

Physical Environment

28

25

20

Air pollution - particle matter

-

10.8

11.7

11.7

9.5

Drinking water violations

-

14%

7%

27%

0%

Severe housing problems

--

--

11%

24%

9%

Driving alone to work

--

--

81%

54%

71%

Long commute - driving alone

--

--

35%

35%

15%

* 90th percentile, i.e., only 10% are better.

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Department Highlights - 2013 their tetanus vaccinations. The Department conducted an assessment to estimate the number of vaccinations that were needed, from the State Stockpile . A complete 500-person vaccination go-kit was already on hand with required ancillary supplies for vaccination. After successfully completing the request process through the County Emergency Manager for vaccine, clinics were scheduled and publicized. Press releases were developed to promote the clinic in the City of Oneida and Town of DeRuyter. Hundreds of bottles of hand sanitizer were purchased by the Department and handed out to residents during each tetanus vaccination clinic to help prevent illness during cleanup efforts.

Public Health Response - Flood At the end of June and into the beginning of July, the Health Department provided support to emergency operations and recovery after flooding in the City of Oneida and Town of DeRuyter. Within the first 48-72 hours, the department activated its incident command to support recovery efforts by providing public information and risk communication, assessing medical needs and providing vaccinations, in addition to providing consultation and support through technical assistance. Key support activities involved coordination and teamwork between all five divisions of the Health Department.

The Department responded to concerns associated with contaminants in the floodwater, the shutdown of the wastewater treatment plant, the issuance of a boil water order due to a water main break, ensuring shelter needs were ad-

The Department was able to quickly start clinics after working through the City EOC to identifying that flooding and debris cleanup posed a potential health risk to residents not current on

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dressed, working with Karing Kitchen and Red Cross, such that meals were provided safely for those displaced, and regularly attending Incident Command briefings. After the floodwaters subsided, staff worked with the two affected restaurants on cleanup and re-opening, attended community meetings to provide guidance on cleanup and mold concerns, provided mosquito dunks to distribution centers for use to reduce mosquito breeding and nuisances, and addressed the flooding and failure of an on-site wastewater treatment system serving a mobile home park.

where people were going to get food and meals, cleaning supplies, and clothing. Health educators visited and provided clinic, cleanup, and infection prevention resources to the local soup kitchen and church providing meals to affected residents, the American Red Cross shelter and Point-of-Distribution (POD) site, and City Hall.

In flooded areas, people were without power and were temporarily displaced. Getting messages and information out took a “boots on the ground� approach by staff delivering copies of releases, posters, flyers, and frequently asked questions and answers directly to affected areas

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Department Highlights - 2013

2013 Community Health Assessment and Health Improvement Plan 10


physical activity, and promote mental health and prevent substance abuse.

Community Health Improvement Plan

The CHIP documents are available on the Health Department’s website in PDF and flipbook form (http://.issuu.com/cjcoe63).

The Community Health Improvement Plan (CHIP) is a long-term, systematic effort to address public health issues in Madison County. The plan is based on the results of a Community Health Assessment, and is foundational to the community’s health improvement process. The Health Department engaged a broad spectrum of representatives from community agencies who played an integral role in the development of the plan goals and strategies.

Healthy Community Design: Smart Growth

The Health Department, in partnership with the Madison County Planning Department, the City of Oneida Planning Department, the Village of Chittenango, the Town of Brookfield, USEPA, and the Renaissance Planning Group, a nationally recognized planning firm, tested and finalized the Smart Growth Audit Tool for Madison County. In February 2013, The Renaissance Planning Group and USEPA representatives attending meetings with community leaders and interested community members in Oneida, Chittenango and Brookfield to test the draft Tool specifically tailored for Madison County. We had great participation at each meeting, and the feedback we received will be used to improve the Tool for eventual use throughout the County.

The CHIP provides guidance to all who live and work in Madison County for improving the health of the population and communities. The plan is fundamental for developing policies and defining actions to target efforts that promote health. Government agencies, including those related to health, human services, and education, use the Community Health Improvement Plan in collaboration with community partners to set priorities, implement initiatives, and coordinate and target resources. The Madison County Board of Health established three overarching Strategic Health Directives that work together to prioritize prevention across multiple settings and advance our efforts to build a healthier Madison County: Healthy Care, Healthy Behaviors and Healthy Environment. The three directives were used to frame our health assessment activities as we evaluated health issues across each life stage of life; infants & toddlers, children, adolescents, adults, and older adults.

The Tool is meant to help municipalities facilitate local planning and economic development activities, while fostering health community development. The Tool itself is a set of standards and best practices for rural communities that is specifically tailored for Madison County. In 2014, we plan to make the tool available to all communities and provide technical assistance to municipalities that want to use it in their planning activities.

Through this effort two priority health issues were selected: promote the prevention of chronic disease through healthy eating and

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Department Highlights - 2013 AgeNet The Department, in collaboration with the Madison and Oneida Counties’ Office for the Aging launched AgeNet, a digital communications network in Madison and Oneida Counties that links residents to health and health related information and services. AgeNet provides access to important information on nutrition, chronic disease selfmanagement, health care planning, and much more. Information on these issues and more are shared across numerous agencies and community locations, providing significant cost savings while engaging community members through a centralized platform. At the heart of AgeNet is an on-line resource library of content that can be accessed and shared by all AgeNet member facilities. All members are required to share health, wellness and other educational materials to participate, thus creating an extremely beneficial experience for everyone involved. Currently, AgeNet is provided at five sites

throughout Madison County, including the Madison County Department of Health, with two more sites soon to come online.

Madison County Rural Health Council Responding to the 2009 County Health Improvement Plan’s call for the formation of a formal rural health network for Madison County, the Health Department led a collaborative team of health care and human service providers to establish the Madison County Rural Health Council, Inc., a non-profit organization, in April 2013. The mission of the MCRHC is “to catalyze information sharing, access to healthcare and linkages among providers to improve the health of people in Central New York,” with an emphasis on primary and preventive care services that provide an economic benefit to both provider and community. The MCRHC is led by a seventeen (17) member board of directors comprised of the main health care

AgeNet Ribbon Cutting Ceremony - (From left to right): John Salka, Brookfield Town Supervisor and Chairman of the Public Health Services Committee; Cheryl Geiler, Director of Community Health, MCDOH; Kathleen Bishop, Consultant on Aging; William Magee, NYS Assemblyman; David J. Valesky, NYS Senator.

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and social service providers serving Madison County residents. The MCRHC’s initial focus will be on addressing mental health and dental health care needs in the county, and chronic disease management

combustion products, including carbon monoxide, a known cause of illness and death. The Department is in the process of creating a Healthy Home Guide specific for Madison County that identifies specific housing risks and associated issues that support a health home. This Guide will incorporate smart growth principles to encourage healthy housing development.

The MCRHC was successful in receiving a NYS Health Foundation and Excellus BC/BS award to implement the National Diabetes Prevention Program initiative. The MCRHC partnered with Herkimer HealthNet and the Herkimer County Health Department on a grant application. The funds will be available to train lifestyle coaches on the NDPP and provide this training to residents with diabetes and with pre -diabetes.

Healthy Home Initiative In the spring of 2013, the Department launched its Healthy Home initiative by hosting the Essentials for Healthy Homes Practitioners Course. The training identified root causes of health problems in a home and linked them to seven principals of healthy housing: Keep it dry; Keep

it clean; Keep it pest-free; Keep it ventilated; Keep it safe; Keep it contaminate-free; and Maintain the house. The training was provided by Manfred Real Estate Training Center. Housing conditions can significantly affect public health. Childhood lead poisoning, injuries, respiratory diseases such as asthma, and quality of life issues have been linked to the substandard housing units . Residents of these units are also at increased risk for fire, electrical injuries, falls, animal bites, and other illnesses and injuries. Additional issues of concern include exposure to pesticide residues, indoor toxicants, tobacco smoke, and combustion gases. The burning of oil, gas, and kerosene can release a variety of

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Administrative Services PROGRAM AREAS   

Strategic Planning Data and Records Management Financial Management

The Administrative Services Division provides critical operational support to the four servicebased divisions of the Health Department: Children with Special Health Care Needs, Environmental Health, Health Promotion, and Preventive Health. The Administrative Services division serves the entire department by maintaining centralized cost accounting functions, oversight and direct support of departmental personal and payroll activities, budget development and financial planning, communications and information security, HIPAA and Corporate Compliance, preparation and submission of internal and legally mandated reports, and interpretation and distribution of emerging legislative and policy information. In 2013, the Division focused its efforts on modifying and improving our billing processes and data management systems in response to several changes both at the state and local levels. The Immunization Billing Project The Department was successful in securing a grant from the NYSDOH to develop and implement a subscription-based practice management information system (PMIS) that will streamline and support our immunization and clinical billing activities. We anticipate that the development and implementation of a new consolidated electronic billing system could enhance our billing revenues by approximately 10%, reduce staff time and related costs attributed to billing activities, facilitate pro-

  

Contract/Grant Management Employee Safety and Healthy Work Environment Clerical Support

gram management and quality improvement activities, and support emergency preparedness applications. The project is targeted for completion in September 2014. Early Intervention - State Reform Under reforms enacted to the Early Intervention Program (EIP) in SFY 2012-13, the NYSDOH and its fiscal agent assumed responsibility for management of Early Intervention Program claiming on April 1, 2013. This reform transitioned responsibility for management of provider billing and claiming of third party payers, and payment to providers, from the County to the State. The Division made the necessary adjustments internally to ensure a smooth transition to the state. The County continues to manage all service coordination activities and billing activities specific to service coordination. Preschool Medicaid Billing The Division worked closely with our software vender McGuinness, to get the software up to date with changes in Medicaid billing guidelines. Although this put us somewhat behind in our billing activities, staff have worked diligently to bring our billing activities up-to-date. Time & Activity Tracking System The Division worked with the County’s IT Department to implement a staff time and activity tracking system that will allow us to better assign resources and improve our overall reporting capabilities. With the privatization of the Certified Home Health Agency in 2012, the department found

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Mission The Administrative Division strives to provide proactive support to ensure programs function at the maximum level of cost effectiveness and efficiency while maintaining compliance with policies and procedures. Vision Through teamwork all programs will be supported by dedicated staff in a professional manner creating positive working relationships enabling Departmental viability and administrative efficiency.

itself with a software system that was based on an acute home care nursing model that could not be tailored for our limited use and was costly to maintain. The Division added the MCH Program patients to the new time and activity tracking system to document patient demographics, payer information, insurance authorization, tracking MD order, billing and AR. Electronic Record Management The Division continued its efforts to transition its client records into an electronic record. The division staff worked aggressively to transition home

care records into electronic files in preparation for the discontinued use of the obsolete acute home care system. The Division is now proactively scanning MCH, EI and Preschool charts. This effort has greatly reduced the need for storing hard copy files and save valued office space. Internal Audits/Reviews The Division revised and conducted internal reviews specific to Medicaid billing within our EI, MCH and Pre-K programs. This process has assisted us in improving our billing activities while enhancing our quality assurance and compliance.

Immunization Billing Project - Workshop

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Children with Special Health Care Needs PROGRAM AREAS   

Children with Special Health Care Needs Program (birth—21 years) Early Intervention Program (birth—3 years) Preschool Program (3—5 years)

The Children with Special Health Care Needs Program (CSHCN) provides assistance to families of children with special health care needs who need help in accessing health care, insurance, and other community resources. Additionally, the Physically Handicapped Children’s Program (PHCP) provides financial assistance to ensure quality healthcare for chronically ill and physically disabled children. While the PHCP program in Madison County has been discontinued to new referrals, the program will continue to serve those clients currently enrolled until they no longer qualify or need services. Madison County Physically Handicapped Children’s Program served a total of 10 children in 2013. Services through CSHCN promote and assist families in the establishment of a medical home. Families, especially those who have children with special healthcare needs, may work with many doctors, nurses, and other health care providers in addition to community agencies such as schools, insurance companies and social services. In a medical home, a primary health care provider and the family work in partnership to assure that all the medical and non-medical needs of the child are addressed. Early Intervention Program The Early Intervention Program (EIP) is a familycentered program for disabled or developmentally-delayed children, birth to three years of age, and their families. Services include evaluation, screening, special education teacher services, occupational, physical, and speech therapies. Through the Child Find Program, children who are at risk for developmental delays are monitored and screened. Staff works closely with a child’s primary care provider to monitor a child’s developmental progress. The Early Intervention Program (EIP) continues to actively partner with community

agencies to provide services to children and families. Early diagnosis and services can help special needs children become as self-sufficient as possible. Early Intervention services aim to prevent developmental delays and disabilities from becoming more severe while building on a child’s strengths and supporting the family as a whole. The early years are a critical time for growth and development. Research has shown that Early Intervention works. The sooner a child gets help, the better chances of their success in school and later in life. Madison County Early Intervention Program served a total of 158 children in 2013. Preschool Special Education Program The Preschool Program provides services to disabled and developmentally-delayed children, ages 3-5 years. Services include evaluation, special education teacher services, occupational, physical, and speech therapies. Services are provided at home or in integrated preschool settings, comprised of children with and without disabilities. The Preschool Special Education Program works closely with school districts, Head Start, communitywide therapeutic agencies and licensed individual professionals. Value Management Consultants (VMC) continue to provide assistance with transportation services to children receiving classroom services. Continued participation in Preschool Coalition meetings provides regional coordination among neighboring counties, school districts, and therapy providers. The Preschool Special Education Program fosters an early partnership between the child, family and school district. This early partnership sets the stage for a positive transition from preschool to schoolage services. Many children with behavioral or developmental disabilities are missing vital oppor-

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Mission Children with Special Health Care Needs provides services to overcome barriers and foster the healthy development of children and families within the community. Vision Through collaboration with Health care, Education, Therapeutic and Social Service providers, resources are accessed to meet identified child and family needs. Our commitment to a family–centered strength based approach provides the foundation for maximum growth and potential. tunities for intervention as they are not being identified early. Research shows that early detection and services can significantly improve functioning and reduce the need for lifelong interventions. Madison County Preschool Special Education Program served a total of 224 children in 2013. On–Site Review On-site review of Children with Special Health Care Needs information and referral services, including Physically Handicapped Children’s Program, was conducted by New York State Department of Health Regional Office staff on March 18, 2013. Results were favorable with minor suggestions for improvement.

Madison County Department of Health Early Intervention Program has met measured performance indicators for the program years of 20092010 and 2010-2011 (the most recent reports available). The Department’s management of Early Intervention provider contracts and fiscal management and payment of Early Intervention claims was transitioned to NYS DOH responsibility on April 1, 2013. Madison County Department of Health’s Early Intervention Program established a provider agreement with NYS Bureau of Early Intervention as a provider of Service Coordination and Special Instruction services.

All 58 Municipalities in NYS are required to be in compliance with specific federal and state Early Intervention performance indicators, which are monitored by NYS Department of Health.

EARLY INTERVENTION PROGRAM

2009

2010

2011

2012

2013

Total number of referrals

109

131

142

161

185

Number of children served

180

195

194

145

158

Number of itinerant served

141

171

165

167

152

Number of center-based served

56

83

75

69

72

74

63

43

30

10

PRESCHOOL SPECIAL EDUCATION PROGRAM (AGE 3-5)

PHYSICALLY HANDICAPPED CHILDREN’S PROGRAM

Number served

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Environmental Health PROGRAM AREAS         

Radon Awareness Lead Paint Hazard Reduction Internships and Youth Development Water Supply Protection Sewage Disposal Realty Subdivisions Regulatory Inspections Food Protection Community Sanitation

The Environmental Health Division continued in 2013 to meet or exceed all performance requirements mandated under Article 6, Subpart 40 of Public Health Law, including the permitting and inspection of 330 food service establishments and 283 temporary food service operations, conducting annual sanitary surveys and providing technical assistance to 115 public water systems that provide drinking water to Madison County homes and businesses, and ensuring the compliance of 105 other permitted facilities subject to NYS Sanitary Codes. Division Staff continued to exhibit competence engaging in those daily activities necessary to protect the health of the public, and regularly attends and completes trainings mandated to conduct such activities. Engineering plans for water system improvements and expansions, realty subdivisions and individual on-site wastewater treatment systems are reviewed for conformance with enacted standards, and the completed works certified for construction compliance. Public health nuisances are promptly investigated and the responsible party engaged to correct and eliminate those conditions posing a risk to public health. The Division conducts surveillance programs and responds to reported exposures of humans to rabies-suspect wildlife, monitors for vector-borne disease, and conducts compliance checks intended to reduce exposure to secondhand smoke and the sale of tobacco products to youth of Madison County.

       

Temporary Residences, Campgrounds, Cottages Children's Camps Swimming Pools & Bathing Beaches Mosquito Surveillance & Vector Control Clean Indoor Air Act Regulation of Tanning facilities Migrant Farm Worker Housing Adolescent Tobacco Use Prevention Act (ATUPA) program

Flooding Event Responding to the major rainfall event that resulted in the flooding of the Flat’s area in Oneida found the Environmental Health Division prepared and taking prompt action to addressing issues related to the event that prompted the evacuation of over 150 homes and numerous businesses. The Division responded to concerns associated with contaminants in the floodwater, the shutdown of the wastewater treatment plant, the issuance of a boil water order due to a water main break, ensuring shelter needs were addressed, working with Karing Kitchen and Red Cross, such that meals were provided safely for those displaced, and regularly attending Incident Command briefings. After the floodwaters subsided, staff worked with the two affected restaurants on cleanup and re-opening, attended community meetings to provide guidance on cleanup and mold concerns, provided mosquito dunks to distribution centers for use to reduce mosquito breeding and nuisances, and addressed the flooding and failure of an on-site wastewater treatment system serving a mobile home park. Staff further responded to flooding events elsewhere in the County, which caused environmental impacts and need for action, including closure of beaches affected by high water, fuel oil spill on premises of a permitted food service, and further distribution of larval control dunks to prevent mosquito breeding in flood areas.

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Mission Enhance the quality of life in Madison County by implementation of effective and efficient environmental health programs to protect the public health, safety and the environment. Vision Essential environmental services shall be provided with honesty, integrity and respect by knowledgeable staff dedicated to excellence and focused on the needs of our community. Food Service All food service establishments and institutional food service operations were inspected in 2013, and over 82% of all temporary food service events permitted were inspected. A total of 28 new restaurants, mobile food vendors and caterers started operation in 2013. Staff held office conferences, conducted field visits and performed plan reviews to assist the new owners in meeting the requirements of the NYS Sanitary Code prior to permits being granted, as well as providing food safety training to the operators and their food service staff. The health risks associated with an unpermitted wild game dinner open to the public were conveyed to the organizer of the event, and through continued outreach and education, secured a cooperative arrangement with the church pastor that allows the church to hold public food events in accordance with NYS regulations. Vector Control The Division continued to engage in early awareness outreach efforts with the neighboring counties encompassing the Oneida Lake basin and its mosquito breeding grounds, and promoting a re-

gional approach to target the prevention of mosquito-borne disease, specifically Eastern Equine Encephalitis and West Nile Virus. Using funds provided to the CNY Counties from the NYS Assembly, Fight the Bite signs were secured for posting and advising on personal protection measures to take to prevent exposure to mosquito-borne disease, and EH staff worked with the Great Swamp Conservancy to erect an educational kiosk to raise awareness of mosquito-borne disease. Water Assistance was provided to various municipalities with well water sampling and/or technical support, to enhance financial assistance applications for the extension of municipal water service to areas experiencing poor well water conditions. Water line extensions were completed along Route 20 in the Town of Madison, by OCWA as part of Town of Lenox Water District #12, and in the Town of Sullivan, to improve water service along Lakeport and Lestina Roads. Sewers The Bridgeport Sanitary Sewer project is nearly complete. The sewers have been connected to the Harbour Town realty subdivision, which will elim-

19


Environmental Health Data inate any further need for the hold & pump arrangement previously being utilized for wastewater disposal, by those townhouses completed to date at this marina setting on Oneida Lake. In addition to allowing the 94-home development to proceed, the sewer project will eliminate the use of sub-standard septic systems within environmentally sensitive areas along the south shore of Oneida Lake, and allow for further development along the Town of Sullivan’s Route 31 corridor. Other residential subdivisions approved or otherwise had plans under review in 2013, included Section 3 of the Northridge subdivision in Sullivan (26 lots), the Greenleaf Station and South Meadows developments in Cazenovia (45 lots), the Pratt Subdivision in Stockbridge (14 lots), and the recently proposed Brookside Crossing duplex project in Oneida (48 units). Built Environment The Division participated in various initiatives intended to improve healthy lifestyles in the County, including assisting with the EPA Grant-funded development of a Smart Growth Audit tool, the start of developing a Healthy Homes initiative to integrate a holistic approach to identifying and eliminating unhealthy environmental conditions in a home, and the preparation of the Healthy Environment Profile component of the Health Departments Community Health Assessment. Radon A three-year coordinated effort between the City of Oneida Planning Department and the Madison County Department of Health (MCDOH) is now in its third and final year. The City of Oneida obtained a grant from New York State Homes & Community’s Renewal Housing Rehabilitation Program. These renewal and energy saving efforts have benefitted many City of Oneida homeowners and the general community as well. The New York State Department of Health provided radon test kits to the MCDOH for the City of Oneida to test a total of 48 homes undergoing energy rehabilitations during the three-year period. MCDOH staff advised the placement and protocol for the tests.

As of 2013, none of the homes tested by the City of Oneida program have shown elevated levels of radon high enough to require mitigation. The program provided for radon testing before any other rehabilitation or energy saving mitigation was completed, ensuring that once the homes are repaired, they were also healthy environments in which to live. This program increased the total number of homes tested for radon gas in the county and furthers a greater understanding of the overall radon risk in the City of Oneida and the county. Rabies Responding to the public health threat of the rabies virus endemic to the County continues to be a priority. In addition, the Division conducted rabies clinics where vaccinations of approximately 1,600 pets were provided. Responding to the rabies threat is expected to be further challenging in 2014, as we experience increasing incidents of rabies within our Ag community. A cow tested positive for rabies for the second consecutive year, and rabies was also confirmed in a fox and a skunk. These exposures and related incidents where the suspect animals were unavailable for testing resulted in 15 persons being authorized to receive rabies prophylaxis treatment. Tobacco All 55 tobacco retail establishments were subject to compliance checks conducted as part of the Adolescent Tobacco Use Prevention Act. One establishment was fined for allowing a sale to a minor, and paid a fine of $550, while another establishment was fined $100 for failing to post the signage mandated by the ATUPA law. While actual sales remain low, the number of retail establishments selling tobacco products increased in 2013, including the Family Dollar chain, with stores in Chittenango, DeRuyter, Hamilton and Canastota. Training Following consecutive years where small tanning salons elected to eliminate tanning beds due to new regulations imposed by NYS, a national chain opened two new tanning salons in 2013. Zoom Tan salons were opened in Oneida and Chit-

20


tenango, and were promptly cited for operating without permits and enforcement action was taken. All 11 tanning salon operations were issued two-year permits and received inspections in 2013. Training remains an important factor in maintaining a competent and professional staff. Staff completed the mandated Basic Environmental Health Program, ServSafe and Food Safety Inspection Officer II training, the Certified Pool Operators course, Lead Hazard Assessors Certification training, the CDC Essentials for Healthy Homes Practitioners training, and regional training related to Ag Fairs, Mass Gatherings, Tanning and Onsite Wastewater Treatment Systems design standards.

Fees Whereas fees for permitted facilities had not been significantly increased since 2007, a fee versus cost analysis was conducted, as well as an assessment of fees charged by other comparable county health departments. A resolution to equitably raise fees for permitted facilities was subsequently enacted by the Board of Supervisors in 2013. Weights & Measures Weights & Measures was consolidated into the Environmental Health Division in 2013, creating efficiencies and eliminating the need to support separate off -campus housing of the W&M Director.

2489

2991

2013 Environmental Division Program Hours

Program

21

93

78

49

394

129

171

226

275

525 109

300

452 169

318

182

125

50

142

805

923

1090

Hours

Total Hours


Environmental Health Data INSPECTION STATISTICS MADISON COUNTY JANUARY 1, 2013 - DECEMBER 31, 2013 Number of Inspections

Number Active Operations

Number Active Operations Inspected

1 1

1 1

1 1

Freshwater River

0

0

0

Impoundment/Pond

4

3

3

Lake

12

8

8

Ocean Surf

0

0

0

Other Saltwater Total

0 16

0 11

0 11

19 19

16 16

15 15

Day Camp

3

3

3

Day Camp - Developmentally Disabled

1

1

1

Day Camp - Municipal

0

0

0

Overnight Camp

5

5

5

Overnight - Developmentally Disabled

0

0

0

Overnight Camp - Municipal

0

0

0

Traveling Day Camp Total

0 9

0 9

0 9

173

112

112

Catering Operation

4

4

4

Frozen Desserts

0

1

0

Commissary

0

0

0

Restaurant/Catering Operation

53

30

30

Bakery

7

7

6

Delicatessen

3

1

1

Tavern

11

10

9

Ice Cream Store

2

2

2

Program Agricultural Fairgrounds Agricultural Fairgrounds Total Bathing Beach

Campground Campground Total Children's Camp

Food Service Establishment Restaurant

Ice Manufacturer

0

0

0

Food Service Establishment

51

53

43

Total

304

220

207

22


Number of Inspections

Number Active Operations

Number Active Operations Inspected

School K-12 Food Service

49

24

24

Institution Food Service

4

3

3

Religious, Charitable, Fraternal Organization

15

15

13

Children's Camp Food Service

6

3

3

Children's Camp\USDA Food Service

0

0

0

Children's Camp\State Education Food Service

0

0

0

Day Care Center Food service

14

12

12

Adult Feeding (Non-SOFA)

2

2

2

Nutrition for the Indigent

2

2

2

College Food Service

36

20

20

Total Migrant Farmworker Housing

128

81

79

1 1

1 1

1 1

Mobile Food Operation

19

16

16

Religious, Charitable, Fraternal Organization Total

0 19

0 16

0 16

26 26

24 24

24 24

Community Water Supply

44

38

38

Non-Community Water Supply

69

60

58

Non-Transient, Non-Community Water Supply Total

22 135

17 115

17 113

SED Food Preparation Site

0

0

0

SED Satellite Feeding Site

0

0

0

SED Self Preparation Feeding Site

2

2

2

SED Satellite/Preparation Site Total

0 2

0 2

0 2

SOFA Prep Site - State Office for the Aging

2

1

1

SOFA Satellite Site - State Office for the Aging

11

10

10

Total

13

11

11

Program Institutional Food Service

Migrant Farmworker Housing Total Mobile Food Service Establishment

Mobile Home Park Mobile Home Park Total Public Water Supply

SED Summer Feeding Program

SOFA Food Service

23


Environmental Health Data Number of Inspections

Number Active Operations

Number Active Operations Inspected

Swimming Pool - Indoor

4

3

3

Swimming Pool - Outdoor Total

8 12

8 11

7 10

Tanning Only

3

2

2

Salon/Spa

3

3

3

Fitness Total

6 12

6 11

6 11

242 242

283 283

233 233

Interior corridor - Two Story Building

2

2

2

Interior corridor - Three Story Building

6

6

6

Exterior Corridor - Single Story Building

4

3

3

Exterior Corridor - Two Story Building

2

2

2

Exterior Corridor - Three Story Building

0

0

0

Exterior Corridor - Four or More Story Building

0

1

1

Cabin or Bungalow Colony Total

7 21

7 21

6 20

Program Swimming Pool

Tanning Facility

Temporary Food Service Establishment Temporary Food Operation Total Temporary Residence

Adolescent Tobacco Use Prevention Activities and Clean Indoor Air Act Adolescent Tobacco Use Prevention Activities *

Clean Indoor Air Act

Active Retail Facilities

55

Complaints Filed

6

111

Complaints Investigated

6

Adult Compliance Checks Retail Facilities Compliance Checks With Minor Retail Facilities

61

* Madison County currently Nuisance Abatement Program Nuisances Total Nuisances Resolved

72 62

Lead Poisoning Prevention Program

Lead Poisoning Prevention Program

Referrals (Blood Lead Level 15 ug/dl or greater)

0

Referral Closed 1/1/2013-12/31/2013 Field Visits (Blood Lead Level < 15 ug/dl)

1 2 24


Rabies Program Animal Bite Referrals

186

Animals Submitted for Rabies Testing

41 Animals Positive for Rabies

Animal Quarantines Due To Exposure

20

Total Rabies Prophylaxis Treatment Authorized

15

General Rabies Inquiries

87

Rabies Clinics Offered

12

Total Dogs Vaccinated

1182

Total Cats Vaccinated

407

Total Ferrets Vaccinated

10

Total Goats Vaccinated

0 Realty Subdivision Declination of Review

Declination of Review

61 Freedom of Information Act Requests

Foil Requests

15 Mosquito Surveillance Program

Mosquito Pools Submitted

253

Positive West Nile Virus Positive Pools

3

Positive Eastern Equine Encephalitis Positive Pools

1

Highlands J Virus Pools Positive Pools

1

Jamestown Canyon Positive Pools

1

Plan Reviews Safety Plan (Bathing Beach, Children's Camp, Swimming Pool)

31

Engineering Plan Review

52 Surveillance Sample Program

Bathing Beach Fecal Coliform Analysis

23

Public Water Supply Coliform Analysis

157

Public Water Systems Organic Inorganic Analysis

11

Public Water Systems Iron and Manganese Analysis

2

Public Water Systems Nitrate Analysis

13

Public Water System Arsenic Sampling Analysis

4

25


Health Promotion PROGRAM AREAS     

Healthy Environments Healthy Behaviors (nutrition, physical fitness, immunizations, personal hygiene) Public Health Preparedness Health Care Information Injury Prevention

The Health Promotion Division is a multidiscipli-

Certified Child Passenger Safety Technician Training 23 staff from 12 organizations across Madison, nary area of public health practice that draws on Oneida, and Onondaga Counties attended a 4-day the social and behavioral sciences and from the National Child Passenger Safety Certified Training scientific fields of health promotion, social market- Course, held April 9th-12th, at New York State Poing, and health and risk communication. lice Troop D Headquarters in Oneida. As part of the Safe Kids Upstate NY Coalition, Health PromoThe Division is focused on creating, communicating, and delivering health information and inter- tion staff helped coordinate and promote the trainventions that are essential to meeting health infor- ing. In addition to presenting to the class on how mation needs of our communities. We apply tradi- to organize and staff a car seat check, Health Promotion staff also coordinated and promoted the tional marketing theories and principles and add event held at Nye Ford on the final day of training science-based strategies from prevention, health promotion and health protection to guide work in to give new technicians hands-on experience workpublic health research, interventions, preparedness, ing with parents and children. 12 car seats were checked and 5 unsafe or inappropriate seats were and education and communication campaigns. replaced. As a result of this training, Madison Bike Helmet Giveaways County now has 3 additional car seat technicians A Bike Helmet Giveaway, held in conjunction with who can check seats at events. the Screen Free Week Family Fun Night at MorrisCar Seat Checks ville State College on May 2nd , resulted in 46 helmets fitted to the children who came from all over The department, in partnership with the Madison southern Madison County. Helmets were fitted by County Sheriff’s Office and the NYS Police, spona deputy from the Sheriff’s Office and 2 volunteers sored an additional 3 car seat checks held in Canastota, Hamilton, Oneida. Certified car seat technicians from the Morrisville Lions Club. As a result of atchecked 56 seats and replaced 14 unsafe seats. tending this event, Fidelis Care offered to provide $500 worth of bike helmets for a helmet giveaway Eating Well with Diabetes to be held in Canastota. A second event was held Eating Well with Diabetes was held in partnership on June 20th at ZEM’S Ice Cream and Mini Golf, with Madison County Office for the Aging, Inc. A with 68 helmets distributed to children. This event program was held in Hamilton in the spring and in was co-sponsored by the Madison County Sheriff’s Canastota in the fall. Both sessions were filled to Office, Safe Kids Upstate NY, and Fidelis Care. capacity. Breastfeeding Friendly Childcare Centers The department worked with the 6 childcare centers in the county that have infant rooms toward receiving the Breastfeeding Friendly Childcare Center designation from the NYS DOH.

Emergency Preparedness The department and Central New York Medical Reserve Corps partnered with Karing Kitchen, a local food pantry in the City of Oneida, to offer emergency preparedness kits to 70 low-income residents, many of whom were also impacted by

26


Mission Using evidence-based research and practices, the Health Promotion Division designs and develops strategies to communicate accurate health information and deliver quality programming for residents to increase knowledge and skills and to positively influence policy and practices, improving health and quality of life. Vision The Health Promotion Division strives to engage the community in order to positively impact the health decisions and the environments of individuals, families, and communities. recent heavy summer flooding. A Medical Reserve Corps Volunteer gave ideas and tips for stockpiling on a budget. A state emergency preparedness grant provided funding for the kits. During the severe summer flooding in the City of Oneida, the division worked to provide timely risk communication messaging to residents on where to get tetanus vaccinations, how to prevent mosquito bites, how to clean up after a flood, and how to prevent illness from exposure to flood waters. Educational materials and flyers were provided at town hall meetings and at the American Red Cross Distribution site for 2 weeks following the local disaster. The Health Promotion Division rapidly pushed out information on vaccination clinics, mosquitocontrol, and flood cleanup through four news releases and mass distribution of information sheets and flyers. In flooded areas, people were without power and may have been temporarily displaced. Getting mes-

sages and information out took a â&#x20AC;&#x153;boots on the groundâ&#x20AC;? approach by staff delivering copies of releases, posters, flyers, and frequently asked questions and answers directly to affected areas where people were going to get food and meals, cleaning supplies, and clothing. Health educators visited and provided clinic, cleanup, and infection prevention resources to the local soup kitchen and church providing meals to affected residents, the American Red Cross shelter and Point-of-Distribution (POD) site, and City Hall. The department presented to 10 counties in the State by webinar, along with a representative from NYS Department of Health IT, on how Madison County continues to stay prepared and at the ready by using eHealth Scheduling software everyday. The software, purchased using state emergency preparedness grant funding, provides online appointment scheduling and account management for vaccination clinics, with a component to assist with billing.

27


Preventive Health PROGRAM AREAS    

Disease Control and Prevention Communicable Disease Investigations Immunizations Sexually Transmitted Infections Referrals for Screening and Treatment

The Preventive Health Services division focuses on health promotion, illness and injury prevention, and health maintenance. Programming is designed to promote the highest level of health for Madison County residents through health education and outreach, prevention of illness and injury, disease control and surveillance, and health care planning. Flooding Event In July 2013, the Preventive Health Services staff provided support to emergency operations and recovery following flooding in the City of Oneida and Town of DeRuyter. The division activated vaccination clinics where it provided over 540 Tdap vaccinations to residents, workers, 1 st responders, and volunteers effected by the flooding. Disease Control & Prevention Disease control staff monitor disease activity and conduct epidemiological investigations of disease occurrence throughout the county. In 2013, staff conducted 536 disease investigations; a 20% increase compared to 2012. Our community partners receive updates and information on disease activity for the county, state and country through a periodic report from the Department’s Disease Surveillance and Response Committee (DSRC). The DSRC works with community-based partners to facilitate the communication of timely and factual disease information. The DSRC reports local disease activity and plays an essential role in updating partners on emerging illnesses, influenza activity, vaccination, and in relaying risk communication messages, such as those delivered during the summer flooding event. Partners, including

  

Tuberculosis Screening and Prevention Maternal and Child Health Education & Home Nursing Visitations Lead Poisoning Prevention

schools, provider offices, universities, and day cares routinely report influenza-like illness to the department, contributing valuable information to our active disease surveillance and monitoring activities in the county. In addition, the DSRC develops and disseminates a monthly animal disease surveillance report using information and data gathered from local veterinarians. The New York State Department of Health instituted communicable disease (CD) performance measures in 2013. It is with great pleasure to report that the communicable disease staff obtained a performance score of 100% for all 3 categories required by NYSDOH specific to timeliness of CD investigation initiation and completeness of CD investigations. In 2013, the division administered 671 flu shots and 1710 immunizations to clients. The Department’s annual flu clinics began in September where we initially target senior centers, schools and Healthcare workers. Department staff implemented a new mask policy in response to the New York State Health Department regulation that requires clinic and home visiting Health Care Workers (HCW) to wear masks if they do not receive an annual influenza vaccination implementation. Ninety-three percent of MCDOH clinic and home visiting staff were immunized against flu. The Department offered immunization clinics in Wampsville, Morrisville and Brookfield throughout the year. The Department hosts immunization clinics by appointment, every Friday at the Wampsville facility and provides free vaccines to children up to age 19 that qualify for the Vaccines for Children Program through the NYS Immun-

28


Mission The Preventive Health division provides education, programs and services necessary to promote health in the community. Vision It is with pride that we take responsibility for providing programs and services that help reduce disease, educate and support children and their families and promote health in the community with integrity and compassion. By partnering with businesses, non profit organizations, schools and healthcare professionals, we will strive to empower individuals to make healthy choices to improve their quality of life. ization Program. National shortages in PPD Tubersol速 for Tuberculosis (Tb) screening and Tdap Boostrix速 and Adacel速, tetanus and pertussis vaccines, created waiting periods for many residents and students until adequate supplies arrived. Zostavax (the shingles shot) vaccine was offered weekly in routine immunization clinics for individuals over age 60 years. Chest clinic services continued with the guidance of Infectious Disease Associates with 5 clients seen and monitored throughout the year. In 2013, 212 Tb screening tests were completed. The Division continues to work to expand immunization services in coordination with the Mohawk Valley Immunization Alliance (MVIA) and Oneida and Herkimer Counties to promote the benefits of immunizations in the region. The Division acts as a resource for local providers and schools on the NYSIIS (New York State Immunization Information Services) via the Health Commerce System. Department staff attended user group meetings and forwarded this information to our local providers that were unable to attend.

Program staff visited summer camp programs to provide information and education to camp personnel regarding disease control requirements including; isolation of ill campers, medicine lockboxes, disease reporting, proper tick removal, epi-pen requirements and use, and notification protocols to the health department for any communicable illness, e.g., strep throat, GI illness or cryptosporidiosis. The Sexually Transmitted Infection (STI) clinic services are provided through a contract with Mohawk Hudson Planned Parenthood with approximately 260 clients each year. Services include STI testing, testing for HIV, and immunization to provide protection from Hepatitis B. Beginning in 2014, our services will include testing for Hepatitis C. Cancer Screening Services The Department is part of a three-county collaborative, led by Oneida County Health Department that receives grant funds from the Cancer Screening Services Program (CSSP) through New York State. Through the CSSP residents in the three county area that are under- or uninsured are provided comprehensive breast, cervical and

29


Preventive Health colorectal screening services. Health educators visit local providers, agencies, businesses and each immunization clinic to provide CSSP information. Maternal & Child Health Home visiting services are provided to pregnant women and infants referred to the department by their providers. A total of 315 clients were enrolled in the MCH program in 2013, which represents approximately 61% of the individuals referred to the program. Those individuals not enrolled either refused the service or could not be contacted. Canastota Central School Kindergarten class presented a classroom-created quilt to MC preventive staff, who in turn, presented quilt to new mother and her infant through the MCH program. Public health nurses conducted outreach efforts to our county’s growing Amish population to provide them information about newborn screening. Nursing staff provided education and referrals to community-based agencies, such as WIC and Healthy Families of Madison County. This year, education with safe sleep messages included a sleep sack provided by Safe Kids Upstate NY Coalition. The MOMS program, a Medicaid health insurance program, closed on January 1, 2013. All clients were transitioned to MCH home visiting with a Public Health Nurse assisting with the promotion of early prenatal care, health education provided throughout the pregnancy and the newborn period, and linking to other community-based agencies, such as Healthy Families and Women, Infants and Children (WIC) services. The Healthy Start Partnership is a coalition of breastfeeding advocates including health department MCH staff, WIC, Community Action Partnership of Madison County, Oneida Healthcare Center and private providers. In 2013, the partnership completed trainings in collaboration with Child Care Coalition of Cornell Cooperative Extension to provide certification training that allows Day Care Centers to be certified Breastfeeding Friendly sites. Health Department staff provided radio interviews and news articles with NYSDOH release of the listing of Madison County certified Day Care Centers. The members of the partnership provided outreach and education to consumers, providers and community agencies

about the Breastfeeding Connections and Café through a display board, flyers, and listing of Community Resources circulated throughout the county. The Breastfeeding Connections and Café have International Board Certified Lactation Consultants (IBCLC) and Certified Breastfeeding Counselors (CLC) as a resource for families. The Business Case of Breastfeeding training was held and teams were established to approach local businesses in the county to provide information and support for Breastfeeding friendly services including lactation rooms/spaces. 2013 the partnership created a “warm line” that provides 24 hours 7 days a week contact availability for any breastfeeding family for insight, guidance and troubleshooting. Lead Poisoning and Prevention New York State requires local health departments to provide mandatory guidance and intervention for those families with children who demonstrate blood lead levels >15mµg/dl. In 2013, only 1 child was diagnosed with a blood lead level >15mµg/dl and reported to the department. The Department’s Public Health Nurse and Environmental Health Lead Assessor provided a home visit and education to the family. Over the last three years, the Department has taken more proactive, preventive measures to address childhood lead poisoning in the County. Lead Program staff provided outreach and education to 60 families with children age 1 and 2 years that demonstrated blood lead levels 5-9 mcg/dl. Through this education and contact, the department provides the family with preventative methods to reduce lead poisoning risks in their homes. As a result of these efforts, the department has observed a reduction in the number of children tested with elevated blood lead levels above >10mµg/dl during this same time period. Lead program staff provided outreach to prenatal providers with education resource binders. Staff provided news articles such as “Protecting Children from Lead Poisoning,” and prevention education in concert with the Community Action Partnership for Madison County’s Toys for Tots giveaways in Oneida and Wampsville.

30


DISEASE

2013 Not released by NYSDOH

AIDS California Serogroup Arbo Virus Neuroinvasive

2012 Not released by NYSDOH

2011 Not released by NYSDOH

2010

2009

Not released by NYSDOH

Not released by NYSDOH

1 probable

0

0

0

0

CAMPYLO BACTERIOSIS

15

13

24

22

14

CHLAMYDIA

183

152

131

122

113

7

16

7

12

10

1 probable

0

0

0

0

STEC, non E-COLI 0:157

3

1

2

1

1

HEP A

0

0

0

0

1

HEP B (ADULT)

2

0

1 chronic

0 chronic

5 chronic

HEP C

9

1 acute 18 chronic

2 acute 11 chronic

0 acute 17 chronic

28 chronic

GIARDIASIS

19

1

10

10

9

GONORRHEA

13

6

10

6

7

Haemophilus influenza, type b

1

0

0

0

0

LISTERIOSIS

0

1

1

1

0

LYME DISEASE

36

6

14

8

21

MALARIA

0

0

0

0

0

MENINGITIS - ASEPTIC

2

3

0

0

1

1

0

0

0

1

PERTUSSIS

10

35

6

15

1

Q FEVER

0

1

1

0

0

STREP GRP A, invasive

3

3

6

2

1

STREP PNEUMONIA

4

4

8

7

17

SALMONELLA

8

8

7

14

4

SHIGELLOSIS

1

1

0

3

0

STREP GROUP B, invasive

4

8

6

5

6

SYPHILIS

0

0

0

0

0

TUBERCULOSIS

0

1

0

0

1

LEGIONELLOSIS

1

0

0

1

3

INFLUENZA A lab confirmed

53

255

48

4

178

INFLUENZA B lab confirmed

38

6

32

0

36

Vibrio– non 01 Cholera

0

1

0

0

0

CRYPTO SPORIDIOSIS DENGUE

- BACTERIAL

31


Preschool Special Education, $1,153,896, 48%

Physically Handicapped Children, $5,515, 0%

Environmental Services, $277,339, 12% Consumer Affairs, $71,370, 3%

Administration, $243,543, 10%

32 Consumer Affairs

Environmental Services

Physically Handicapped Children

Preschool Special Education

EI Program

Federal/State Grants

Home Care

Health Promotion and Planning

Preventive Health

Administration

Federal/State Grants, $15,795, 1%

Home Care, ($116,058), -5%

Health Promotion and Planning, $148,197, 6%

Preventive Health, $180,522, 8%

EI Program, $409,393, 17%

Actual County Cost by Program Actual Costs - $2,389,512

Financial Information


Statement of Revenues and Expenses 4th Quarter 2013

Modified Budget

01/01/13-12/31/13

Under (Over)

Actual

Budget

Revenues Public Health Administration

438,524

377,839

60,685

Preventive Health

400,622

442,210

(41,588)

Health Promotion & Planning

241,456

193,808

47,648

Home Care

51,666

120,801

(69,135)

Federal/State Grants

88,477

50,894

37,583

423,586

127,742

295,844

1,817,883

1,627,623

190,260

8,500

(3,231)

11,731

401,341

362,252

39,089

1,500

3,206

(1,706)

3,873,555

3,303,144

570,411

Public Health Administration

658,086

621,382

36,704

Preventive Health

678,635

622,732

55,903

Health Promotion & Planning

427,064

342,005

85,059

0

4,743

(4,743)

83,578

66,689

16,889

852,323

537,134

315,189

3,347,580

2,781,519

566,061

15,000

2,284

12,716

665,129

639,592

25,537

82,591

74,576

8,015

6,809,986

5,692,656

1,117,330

County Share Budget

Actual County Cost

Actual/Budget Comparison

$2,936,431

$2,389,512

$546,919

Early Intervention Preschool Education Physically Handicapped Children Environmental Services Consumer Affairs Total Revenues Expenses

Home Care Federal/State Grants Early Intervention Preschool Education Physically Handicapped Children Environmental Services Consumer Affairs Total Expenses

County Share

33


Organizational Chart MADISON COUNTY BOARD OF HEALTH

MADISON COUNTY BOARD OF SUPERVISORS

******* MEDICAL ADVISORY COMMITTEE

PUBLIC HEALTH SERVICES COMMITTEE

PUBLIC HEALTH DIRECTOR

MEDICAL CONSULTANT/ DIRECTOR

CONFIDENTIAL SECRETARY

ADMINISTRATIVE DIVISION

CHILDREN WITH SPECIAL HEALTHCARE NEEDS DIVISION

ENVIRONMENTAL HEALTH DIVISION

HEALTH PROMOTION DIVISION

PREVENTIVE HEALTH DIVISION

BOARD OF HEALTH

PUBLIC HEALTH COMMITTEE

John Endres, President

John Salka, Chair

John Salka, Vice President

Roger Bradstreet

Margaret S. Argentine

Lewis Carinci

Samuel Barr

James Goldstein

Wendy Cary

Alexander Stepanski

Robert Delorme Rachel Elder

MEDICAL CONSULTANT

Jennifer Meyers

R. Seelan Newton

34


35


Annual Report MADISON COUNTY Department of Health www.healthymadisoncounty.org 漏 2013 PO Box 605 路 Wampsville, NY 13163 315-366-2361 路 Fax 305-366-2697 health@madisoncounty.ny.gov

2013 Annual Report  
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