City of Vineland Health Department Annual Report 2012
Mission Taking Care of Vineland Vision A healthy future for Vinelanders Core Values The commitment toward continuous growth and improvement Quality/Excellence Endeavoring to achieve and maintain a high standard of excellence Integrity Function with honesty and trustworthiness to improve the health of the community Teamwork Solving problems, making decisions, and achieving goals within our organization Accountability Dedication to meet the needs of the community and provision of services Core Goals To promote health, impact policy, and transform healthcare
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Acknowledgments
Governor ……………………………………………………………Chris Christi Lieutenant Governor……………………………………………….Kim Guadagno Mayor………………………………………………………………...Robert Romano City Council …………………………………………………….......Peter Coccarro City Council…………………….……………………………………Edward Conrow Council………………………………………………………………..Douglas Albrecht Council………………………………………………………………..Louis Cresci, JR Council………………………………………………………………..Mayra Arroyo
Vineland Board of Health
President……………………………………………………….…..Peter Coccarro Vice President………………………………………………….….Edward Conrow Board Member…………………………………………….……….Douglas Albrecht Board Member……………………………………………………..Louis Cresci, JR Board Member……………………………………………………..Mayra Arroyo
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Local Public Health Officials
A Public Health Director organizes plans, directs, and manages public health care programs that are specific to county. They ensure that everyone in their department is following federal and state health laws and regulations, provide administrative support to the city business administrator and report to the local board of health. They may also present and monitor the department's budget and ensure the proper processes and resources are in place to respond to emergencies such as disease outbreaks, safety hazards, and other health-related issues.
The Health Officer coordinates resources of health care institutions, social service agencies, public safety workers, or other organizations to improve the community health; develops or implements interventions to address behavioral causes of diseases and directs or manages prevention programs in specialty areas such as aerospace, occupational, infectious disease, and environmental medicine. In addition, Mr. Sartorio performs epidemiological investigations of acute and chronic diseases; provides information about potential health hazards and possible interventions to the media, the public, other health care professionals, and to local, state, and federal health authorities and directs public health programs dealing with topics such as preventable diseases, injuries, nutrition, food service sanitation, water supply safety, sewage and waste disposal, insect control, and immunizations. 7
Table of Contents Executive Summary…………………………………………………..…….9 Department of Health Environmental Health Services…………………11 Vineland Public Health Education………………………………………..23 Public Health Nursing……………………………………………………...26 Individual Clinical Services………………………………………………..32 Vital Statistics………………………………………………………………35 Emergency Medical Services…………………………………………….39
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Vineland Local Public Health Annual Report This is the 2012 Annual Report for the City of Vineland Health Department which is a city agency charged with providing safe environmental services to the community. Overcoming economic challenges involving healthcare and public health systems has been a creative venture. In order to ensure effectiveness and efficacy, both state and local agencies and programs have met the necessary challenges required to implement evidenced based strategies for quality improvement initiatives including public health goals for the future. The Health Department consists of a dedicated staff of professionals who strive to meet the varied needs of the community by providing a wide range of programs and activities designed to promote, protect and improve the health of all Vineland residents. The department is committed to meeting the needs of the community and to providing accountability for the provision of services. The Annual Report highlights activities, programs, and healthy people 2020 health improvement goals to bring about health improvements in the population. Examples of these programs and activities include: 1) raising public health awareness of local health issues, 2) tracking health trends so that resources can be focused on the most important concerns of our residents, 3) preventing the spread of disease through education and early detection and 4) providing services, activities and programs to increase physical activity and address childhood obesity concerns. The Vineland Local Health Department is working to protect and improve the health of the community. Particular interests include tobacco use cessation, preventable diseases, infant mortality, and protection against foodborne diseases. In addition, the department must increase awareness of the spread of the West Nile Virus and encourage citizens to report related incidents to the Health Department. Also, an increase in DTaP inoculations will be on the agenda for the coming year. One successful accomplishment of the department is its commendable, rapid response to assist in the multi-state investigation of fungal meningitis among patients who received epidural steroid injections. Other major accomplishments were implementing programs to combat obesity by promoting healthy choices and activities, and to reduce chronic disease risk through education consisting of healthful diet programs and the need to achieve and maintain healthy body weights for children and adults in the community. The health officer is a problem solver who develops and evaluates the effectiveness and performance of procedures, interventions, and programs and presents the results in an appropriate way to different groups of stakeholders. He is knowledgeable in organizational behavior, has the capacity to function effectively within the culture of the organization and is an effective team player in obtaining evidential 9
information. In addition, he collaborates with individuals, agencies, organizations and healthcare providers within the community to form partnerships and alliances in order to enhance public health. He also mentors, supports and motivates individuals within the department to enhance on the job performance. Finally, the projections for the next three to five years will incorporate Healthy People 2020 goals. This will improve health by devising strategies and policies to help the community reach its health objectives by assessing community needs and by creating a plan to track progress through community participation and social planning. The interaction between governmental agencies and the private sector is changing the delivery of healthcare. Healthcare reform is a strategy initiated as part of Healthy People 2020. It focuses on eliminating health disparities, increasing quality and years of life, and develping infrastructure for public health activities resulting in improved health benefits from all public health services and regulatory activities.
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Vineland Department of Environmental Health Services HIGHLIGHTS FROM 2012 ENVIRONMENTAL DIVISION Most of the work completed by this division is driven by regulations and minimum standard requirements. The work involved in most environmental programs must be performed by licensed Registered Environmental Health Specialists (REHS) inspectors. All REHS inspectors have a minimum of a Bachelor’s Degree in Public Health or another science and must a pass a State licensing exam. All REHS inspectors are required by State law to obtain a minimum of 15 hours of continuing education in approved public health courses each year. Environmental Health – Consumer Health Body Art Facility Inspections Pet Facility Inspections Recreational Bathing Inspections (Public Pool and Spa Inspection and Enforcement) Retail Food Establishment Inspections and Plan Reviews Tanning Facility Inspections (to start in 2013) Youth Camp Safety Inspections
Environmental Health – Environmental Protection and Services Childhood Lead Poisoning Investigations Control of Rodent Vectors of Disease Indoor Air Quality Investigations Public Health Nuisance Complaint Investigations Rabies Control Septic System Installations, Plan Review and Inspections Well Permits and Inspections. Well Water Complaints Private Well Testing Act What was new in 2012? 11
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Major changes in the NJ septic regulations (see narrative)
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Retail food regulations lowered cold holding temperatures from 45˚ F to 41˚ F.
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The Retail Food Program successfully completed an audit for all 9 standards of the FDA’s Voluntary National Retail Food Program. The FDA is still reviewing the documents. If accepted, we will be the first in the United States to have completed all 9 standards.
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Implementation of the new joint application for mobile and temporary food vendors. Seven (7) southern New Jersey Health Departments worked together to create an application for mobile and temporary food vendors that is accepted by all participating Health Departments.
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Inspection ratings of retail food establishments are now posted on our website.
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The storm of June 30th caused widespread power outages. Retail food establishments were visited to ensure compliance and food safety over that weekend and during the following week. Many man-hours were spent on this disaster.
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Three of our inspectors received scholarships to attend 4 out of state training programs in food safety.
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A feral cat colony ordinance was passed allowing for the registration and existence of feral cat colonies provided they have proper sponsorship and care.
Body Art Under State regulations, we are required to inspect body art facilities. This oversight is to prevent disease transmission, particularly blood borne pathogens. As of 2012: Licensed Facilities………………………….……..3 Licensed Practitioners………………………..…..9 Trailing Edge Ear Piercing Establishments……3 12
Tattoo Body Art Facilities…..…..3 Body Piercing Facilities…………1 Inspections …………………..… 6 Re-Inspections………………….10 Plan Reviews Conducted ….….1 Complaints ……………………...1 Pet Shops We are required by State law to inspect our pet shops, kennels and shelters annually. Ratings are issued after each inspection. All were inspected in 2012. 2012 Stats: Licensed pet shops…………….0 Licensed kennels ………………3 Licensed shelters……………….1 Initial Inspections……………… 5 Re-inspections………………… 6 Complaints………………………3 Recreational Bathing Program This department must conduct inspections on all seasonal public pools before they open each year. A variety of requirements are checked for compliance such as water chemistry and clarity, safety equipment, lifeguard certifications, and bacteriological testing. If any of these requirements are not achieved, the operator will not be permitted to open the pool. During the year, we conduct one routine inspection at seasonal pools and 2 routine inspections at our year round facilities. We also monitor weekly bacteria testing of the pool water for each facility. Any significant issue of non-compliance observed, will result in the closure of the pool. A re-inspection is required in order to reopen the facility. Plans must be submitted to this Department for review and approval prior to the construction of new public pools. The review of these plans is very intense and time consuming because there are many details that must be checked. Once a pool is 13
installed, the operator must obtain a construction inspection from this department to ensure that the pool was constructed in strict compliance with the approved plan. In 2012, we licensed 34 recreational bathing facilities including 24 seasonal pools, 5 hot tubs/spas, and 5 year round pools. All facilities were inspected as required. We closed recreational bathing facilities 22 times in 2012. Compliance ratings are issued after each routine inspection. All 3 inspectors involved in this program are certified pool operators. In addition, they take other training courses throughout the year to maintain their knowledge and sharpen their skills. We are expecting new regulations from the State in 2013. Retail Food Program Our licensed Registered Environmental Specialists spent most of their time in the retail food program. The program goal is to ensure safe food for the public through efforts such as: inspections with mandated correction of significant issues; increasing awareness of food safety with food handlers, managers, owners and the public; legal action when necessary; investigation of outbreaks, and closure of a facility if deemed necessary to protect the public. We view food safety as a partnership between retail food establishments and this department. We have roughly 450 retail food establishments operating at any given time in the City of Vineland. During inspections, which are unannounced, we look at all aspects of the operation, but concentrate on the following 5 major risk factors identified by the Centers for Disease Control in Atlanta as causing most outbreaks in this country: •
Poor personal hygiene
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Inadequate holding temperatures (cold, hot and cooling)
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Inadequate cooking temperatures
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Unclean food contact surfaces
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Unsafe food sources
All of our retail food facilities are divided into risk classes 1 through 4 (1 being the least likely to cause an outbreak and 4 being the most likely) New Jersey requires all Health Departments to inspect all retail food establishments at least once a year. We go beyond the minimum requirement by inspecting risk class 3 and 4 establishments twice 14
a year. Inspection ratings are issued after each inspection and are posted at www.vldhealth.org along with explanations of the rating system. Our inspectors in this program are “Standardized” against both the Food and Drug Administration (FDA) and the New Jersey Department of Health (NJDOH) protocols. Standardization occurs every 3 years. We feel it is very important to be consistent and knowledgeable. One REHS is certified as a trainer of other inspectors by the FDA. In 2003, this department joined the FDA’s Voluntary National Retail Food Regulatory Program. This challenged us to continuously improve our own program. There were 9 standards to achieve. We achieved all 9 standards and passed our outside audit in October. The FDA is still reviewing the audit document. If they accept the audit results, we will be the first Health Department in the entire country to have completed the project. We are very proud of this accomplishment. For more details on the program, go to www.vldhealth.org. As part of the FDA program, we created a Vineland Food Safety Council in 2003. The 18 members include various retail food operators, academia, Health Department representatives and one member of the public. Our mission is to promote food safety, especially amongst retail operators. We have had many projects in the past including food safety calendars (created from student posters on specific topics), food safety knowledge contests with substantial prizes, increased the number of food safety classes, and made requests to the school system to include food safety in their curriculum. We have learned much from each other as we work together. We also try to recognize owners, managers and their employees who perform above and beyond the minimum requirements when operating their establishments. In 1993, we started presenting “5-Star” Awards each year to those establishments that meet the strict criteria. Nineteen (19) years later, we are still giving out awards and have at least one establishment that has received the award for seventeen (17) of those nineteen (19) years. We have seen an increase in training and effort as a result. Our Food Safety Council designed the logo that we now use on the certificates and door stickers. In 2012, there were 572 initial inspections for 460 establishments. Eleven (11) percent of the establishments received conditionally satisfactory ratings. The Department investigated complaints and conducted 14 foodborne illness investigations. There were 5 food safety classes conducted including one in Spanish. We are expecting new State regulations in 2014 that will closely mirror the 2009 FDA Food Code.
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Tanning Salon Inspections Tanning salons will be inspected by this department starting in 2013. Tanning salons pose a risk of burning and skin cancer. Unfortunately, according to the World Health Organization (WHO), all people, regardless of skin color, are vulnerable to the effects of immune suppression. Overexposure to UV radiation may suppress proper functioning of the body’s immune system and the skin’s natural defenses, increasing sensitivity to sunlight, diminishing the effects of immunizations or causing reactions to certain medications. Youth Camp Inspections We have a limited role in this program. We are only required to conduct “pre-opening inspections” at licensed youth camps for the New Jersey Department of Health (NJDOH). The areas checked include potable water supply, sewage disposal, food service, record keeping, personnel records and equipment, recreational bathing, and obvious health and safety hazards. No ratings are issued for this inspection. We also investigate complaints for the State, as needed. Food service and recreational bathing within these facilities are fully inspected. Bed Bug Control We periodically receive complaints from consumers or residents about bed bugs. While bedbugs are not known transmitters of disease, they are very much a nuisance. We investigate these complaints when received. We have information packets that we provide when confirmed or suspected infestations are noted. The information includes directions on how to get rid of bed bugs. If the infestation occurs in a multi-family dwelling or complex, we will also direct the property owner/manager to abate. In 2012, we received 9 complaints about bed bugs. Bed bugs are not easy to eliminate. Code Enforcement (Office of Licenses and Inspections) also handle complaints of bed bugs in rental units. Childhood Lead Poisoning Program When the Nursing Division receives a report of an elevated blood lead level in a child that resides in Vineland, we are requested to evaluate lead in the child’s environment that may be contributing to the problem. Three of our REHS inspectors are Lead Inspector Risk Assessors licensed to evaluate the home or babysitting environment for lead. We have 2 methods of conducting that evaluation: an XRF that measures lead in paint, and by taking dust wipe samples. If lead is found, the inspector will then direct and monitor the safe removal of the source. We also have access to equipment that can test plates for lead. 16
Rodent Control Rodents can carry disease that can be spread to humans. In 2012, we received twentythree (23) complaints about rats involving either one property or an entire neighborhood. Ten (10) of those were found to be valid. Orders to abate are sent in all verified cases with follow-ups to ensure the matter is corrected.
Indoor Air Quality Many things can affect the quality of the air inside our homes and places of employment. Mold, bacteria, carbon dioxide, carbon monoxide and odors are the most common issues. We investigated fourteen (14) complaints of poor indoor air quality in 2012, all of which were for mold. Six (6) came from employees of businesses, one (1) concerned a school and seven (7) were from residential tenants or homeowners. We also handle many calls each year regarding requests for information on the health risks and proper abatement of mold. We have two (2) extensively trained REHS inspectors in the area of indoor air quality who handle these complaints, by suggesting methods of abatement or providing advice. There are no specific regulations for enforcement in this area, although in some cases, we can enforce mold remediation in rental properties and places of employment. If a public school is involved in a complaint, we work very closely with the School Board. We primarily investigate these complaints as a service to our citizens. We have equipment to monitor relative humidity (moisture in the air) and moisture in solid materials. Both factors can contribute to mold growth. We also can test for carbon monoxide and carbon dioxide. Carbon monoxide can be lethal at higher levels. Carbon dioxide, which is exhaled when we breathe, can leave us lethargic in levels above 1000 ppm. We help find solutions that will lower the concentrations of these gases. We do not have the equipment to test for mold spores in the air. This must be done by an outside company. We do provide lists of companies who can sample and/or remediate when requested. We are able to take “sticky tape� samples of visible mold for identification. The cost of laboratory analysis for tape samples is the responsibility of the property owner. Public Health Nuisances Public Health nuisances encompass a variety of issues. Mosquitoes, odors, overflowing dumpsters, and flies are prime examples of the nuisance of complaints we receive. In 2012, we investigated thirty (30) general nuisance complaints and twenty-five (25) mosquito complaints. Those twenty-five (25) cases included resident complaints about 17
mosquitoes and routine visits to all of our tire dealers for mosquito control. Water trapped in tires is a breeding place for some species of mosquitos. When mosquitoes or their larvae are found, we work with the Cumberland County Public Works Mosquito Control Division to eliminate or control the problem. When conducting surveillance for West Nile Virus, a mosquito borne disease, we rely on the public to call us about any dead birds that they may encounter so that the appropriate report can be filed with the state. Dead crows and a few other species, the sentinels, are tested for West Nile virus if they meet the testing criteria. In 2012, we received only six (6) calls about dead crows in Vineland. None of the crows were testable due to signs of decomposition. Rabies Program This department must investigate exposures to animals that have the potential to spread rabies to humans or domestic animals. Exposure can occur through bites, scratches or the transfer of virus laden saliva into open wounds or mucous membranes. In 2012, we investigated a total of 126 exposures. Seventeen (17) specimens were sent to the State Lab for testing. Only two (2) specimens tested positive for rabies. Postexposure treatment advice is provided to exposed individuals and/or treating physicians when indicated. In 2012, we held five (5) free clinics to vaccinate dogs and cats against rabies. We vaccinated a total of 1099 dogs and 304 cats. Cats are the most likely animal to transmit rabies to humans because they are more likely than wildlife to have contact with humans. On average, there is one (1) human exposed for every fifteen (15) rabid raccoons; whereas, an average of five (5) humans are exposed for every one rabid cat. Feral cat colonies continue to be a concern because the cats are not vaccinated. In response to that concern, City Council enacted an ordinance that deals with feral cat colonies. This ordinance requires the following: An approved Sponsor The Sponsor must take responsibility for the colony by: •
Evaluating a caregiver’s ability to perform required tasks
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Providing training to each caregiver
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Registering each colony with the City
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Ensuring that the caregiver maintains records on the vaccination and spay/neuter status of the cats in the colony
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Assisting in resolving complaints about the colony or the caregiver
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Reporting quarterly to the city on the status of the colony
A caregiver who agrees to: •
Take all reasonable steps to have the colony vaccinated against rabies
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Take all reasonable steps that will result in 100% of the colony being spayed or neutered.
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Provide food, water and shelter for the colony members. Food must only be provided during daylight hours.
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Monitor health status of colony members and obtain medical attention when needed.
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Remove kittens that are born into the colony and place them in permanent homes or transport them to the SPCA after they are weaned.
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Maintain records as noted above
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Report on status of the colony to the Sponsor as required.
As of December 31, 2012 there are no approved Sponsors or colonies registered in the City of Vineland.
Septic System Program This department is charged with the oversight of the installation and maintenance of individual septic systems that handle less than 2,000 gallons of effluent per day. For installations, our role includes witnessing of soil borings, plan reviews of new and replaced systems, issuance of permits to install, and inspecting excavations and final installations. When a system fails and overflows, we direct the abatement of the overflow and the system failure. In 2012, the State regulations on individual septic systems changed dramatically. A summary of the major changes is provided below: 19
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Local Health Departments can now approve advanced treatment systems. Previously, only the New Jersey Department of Environmental Protection (NJDEP) could approve those systems.
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New specifications were added to cover advanced treatment systems.
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Installers using any proprietary technology, including infiltrative chambers, must be in possession of a valid Certified Installer of Onsite Wastewater Treatment Systems (CIOWTS) certification issued by the National Environmental Health Association (NEHA).
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Professional Engineer (PE) is required for any changes made to the disposal area. A PE must certify any alteration or “in-kind” replacement of a septic system (not involved in a real estate transaction) that does not meet the code.
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Guidelines and inspection forms for the inspection of septic systems on properties involved in real estate transactions were developed.
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For real estate transactions, non-compliant or malfunctioning systems must be brought up to code.
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Cesspools or other non-conforming systems must be brought up to code if there is a malfunction or sale of the property.
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Expanded definition of a malfunction.
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Restaurants, kitchens, etc., discharging large quantities of grease must have a high strength wastewater pre-treatment component designed by a Professional Engineer.
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Change in use of a building requires an Engineer’s certification. Septic design criteria for determining flow are now based on specific usage rather than the “type” of facility.
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All new or replaced septic tanks must be tested for water tightness on site, after they are installed.
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All new or replaced septic tanks must have a National Sanitation Foundation (NSF) approved effluent filter installed at the outlet.
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General construction requirements for septic tanks have changed.
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Septic tanks must now have system specific, permanent, non-corrosive labels.
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Manhole covers must be brought to grade on new systems.
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Requirements for select fill have changed.
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Salt hay and untreated building paper are no longer allowed to cover the stone disposal areas. Only filter fabric is permitted.
One REHS inspector completes all of our septic plan reviews. He must attend classes every year to stay current on all of the regulatory changes and official opinions and interpretations issued by the NJDEP in this area. Plan reviews……………………………..54 New…….…..…………………..…7 Replacements…….……………..47 Soil profile pits witnessed……………….0 Excavation inspections conducted: New…………………………………5 Replacement………………………23 Final Inspections (new)…………………...8 Final Inspections (Replacement)………..37 Re-inspections: New…………………………………3 Replacement………………………8 Complaints………………………………...23
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Well permits and inspections This department is responsible for the oversight of all new and replacement private wells. In this program we review applications and issue permits to drill wells. We witness the drilling of most wells. We also inspect the final installation of wells and review water tests required for all new and replacement wells. We address contamination in the well water and order abatement. Old wells must be properly capped and sealed by a licensed well driller when a replacement well is installed. We also receive a few complaints about well water each year. In 2012 permits issued New…………………………………..4 Replacement………………………..26 Witness installation New…………………………………..3 Replacement………………………..18 Final Inspection New………………………………….3 Replacements……………………...22 Complaints………………………………….6 Private Well Testing Act The Private Well Testing Act requires water testing at properties with private wells as follows: a) Part of a contract and condition of sale, or b) Residential rental properties must be tested at least once every five (5) years. The NJDEP ultimately provides complete results to the local health department. In response to the reports, the Vineland Health Department notifies property owners within 1000 feet of wells that test positive for contaminants that pose a health risk from using or consuming the water. In 2012 Reports received…………………………….35 22
Follow up notifications required…………….12 Five year rental follow ups…………………..14 Initial Rentals………………………………….4
Public Health Education Mission The Health Education Division of the Vineland Health Department strives to improve attitudes, beliefs, and behaviors in order to enhance the health of its city’s residents. Prevention, Promotion & Education The Health Education division continues to keep the public informed about Health Department events and important information through press releases, radio and TV interviews, by operating the Health Department website and by posting communications on social media sites. The Vineland Health Department website at www.vldhealth.org and the social media pages have become an integral tool in disseminating information to the public. Highlights Nutrition and Tobacco Classes were taught to over 576 students in six (6) elementary schools. Vineland Pace Setters is an adult walking program held at D’Ippolito Elementary School, every Monday, Wednesday and Thursday from 6 – 7 p.m. Along with the walking program, older adult education programs such as fall prevention and strength training exercises were offered throughout the year. Forty-six walkers walked a total of 1176 miles throughout the year in 2012. Health Educators attended 38 health fairs distributing literature to 3261 residents.
Grants Received in 2012 NJ Partnership for Healthy Kids (NJPHK) – Vineland
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NJPHK is a statewide program of the Robert Wood Johnson Foundation (RWJF) with technical assistance and direction provided by the New Jersey YMCA State Alliance. •
The goal of the program is to convene, connect and empower community partnerships across the state in order to design and implement childhood obesity prevention strategies that support access to affordable, healthy foods and increase opportunities for safe physical activity.
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The initiative is led by the City of Vineland Department of Health, the YMCA of Cumberland Cape Atlantic and the YMCA of Burlington and Camden Counties.
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NJPHK-Vineland, the Vineland Health Department and Cumberland Cape Atlantic YMCA, and five Vineland corner stores and restaurants partnered to provide more healthy eating choices in the participating retail food establishments. These partners are engaging store and restaurant owners to consider implementing the Food Trust’s Healthy Corner Store Toolkit which helps proprietors increase the availability of fresh produce and other healthy food choices for residents and children.
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NJPHK-Vineland has partnered with the Alliance for a Healthier Generation and the Vineland Public School District on school wellness policy and the formation of a Wellness Council. The school district strengthened its policy. Two Vineland public schools, Landis Intermediate and Petway, qualified for the Alliance’s Bronze award, which recognizes the schools efforts to create healthier menu options.
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City of Vineland Engineering, Planning, Health and Economic Development Departments are joining resources in order to create bike lanes, crosswalks and share the road signage on Elmer and Wood Streets. The project will be completed by May 2013 but the initial groundwork was laid out in 2012.
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The NJPHK – Vineland and the Vineland Health Department created an agreement to work with our public schools to introduce a new Healthy U which is a structured recess program taught during the school day. The Healthy U program is fully implemented and the Fitness Gram pre-test is complete.
Community Needs Assessment Grant: Along with our Community Health Workers, we participated in the Cumberland-Salem Health and Wellness Alliance subcontracted by Family Health Initiatives. We surveyed 800 Hispanic or low socioeconomic residents in Cumberland and Salem counties regarding their personal and community health related needs.
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Back to Basics: Childhood Lead Poisoning Primary Prevention Education Program •
The main purpose of this grant is to increase awareness of the dangers of home based lead hazards and educate Cumberland, Salem and Atlantic county families about inexpensive and practical prevention strategies to reduce exposure, particularly among pregnant women and children living in hard to reach, minority and migrant communities.
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Eighty-four (84) families were educated on the lead dangers in their homes that could put their children at risk for lead poisoning. Families were provided with NJ Wipe out Lead dust wipe kits in order to test their homes for lead.
Campeones Por la Salud (Champions for Health): •
Conducted Two Promotore's Trainings in which Thirty-eight (38) Promotore's were trained.
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Created partnership with American Diabetes Association to provide free materials and staff training about diabetes self-management program.
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Introduction of new clinician directed referral Promotore's de Salud program
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Successfully engaged twenty-nine (29) Medical Providers and five (5) Diabetic Education Agencies signed Memorandums of Agreement (MOU’s)
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Coordinated with Camden Area Health Education Centers to conduct provider Community Health Worker Trainings during next grant cycle.
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Seven Medical Providers are referring Diabetic Patients to our program.
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Public Health Nursing The Vineland Health Department works to control the spread of contagious diseases in Vineland through education, counseling, screening and immunizations.
Contagious Diseases Certain infectious diseases such as salmonella, measles, shigella and others must be reported to the Vineland Health Department. Upon receipt of such reports, Public Health Nursing staff investigates the case or cases in order to control the spread of the disease in the community. To report an infectious disease, or if you have any questions about communicable diseases call 856-794-4000 x 4806.
Flu Shots The Vineland Department of Health offered flu shots to all residents of the City of Vineland. Anyone who wanted to reduce their risk of getting the flu should have gotten a flu shot. Flu shots are strongly recommended for people who are at high risk of getting the flu. At risk groups include: • 50 years of age or older • All children from 6 months to 18 years old • Pregnant women • Diabetics • Heart Disease Patients • Asthmatics • Kidney Disease Patients • Caregivers to infants or the elderly
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2012 PUBLIC HEALTH NURSING STATISTICS January 1, 2012 ~ December 31, 2012
SEXUALLY TRANSMITTED DISEASE (STD) CLINCICS & SERVICES Weekly STD Clinics were held every Tuesday evening at 4pm. Services provided included HIV counseling, testing, and referral of positives to Complete Care for medical evaluation & services. Two HIV positives were identified. One was enrolled in a Pennsylvania HIV immunization study. HIV counseling, testing, & referral services were provided daily on a walk in basis. Patients without money for condoms may make visits to the clinic for a daily supply. Our Environmental Health Inspectors have continued to provide ancillary support in the form of counseling at our STD clinics. Forty six (46) clinics were conducted serving 352 individuals. There were 15 walk-ins for HIV testing. The numbers of patients seen at our STD clinics ranged from 1-16, with an overall average of 8 patients per clinic. Additionally, uninsured adult STD patients received HPV, Hepatitis B/C, Influenza, and Shingles vaccinations if eligible and requested. One hundred twenty-nine (129) gonorrhea and chlamydia tests were performed resulting in thirty-eight (38) confirmed cases of chlamydia and gonorrhea. Two hundred forty-four (244) patients were tested for syphilis. There were 11 positive test results.
BLOOD PRESSURE CLINICS This program encourages cardiovascular health through healthy eating, blood pressure monitoring, and weight loss counseling. City of Vineland Employees and Residents participated in blood pressure (BP) monitoring clinics at various locations throughout the city. 27
A total of thirty-six (36) clinics were held throughout the year at Luther Acres, Kidston Towers, the Senior Center, Electric Distribution, Electric Generation, and at Vineland City Hall. A total of nine hundred ten (910) blood pressure checks were conducted at these clinics.
SHOTS FOR TOTS (VFC) PROGRAM, VACCINES FOR ADULTS (VFA) PROGRAM, CLINICS, & SERVICES Monthly clinics were held (3rd Wednesday of every month) with enhanced services in September and January to accommodate the new school policy which excluded students from schools and day care centers for failure to update immunizations. Daily scheduled appointments & walk-ins for immunizations. A total of 48 school vaccination audits were completed for all Vineland private & public pre-schools and public schools. A total of 1165 vaccinations were administered under in the VFC program and a total of 375 vaccinations were administered under the VFA program. Refer to the Public Health monthly statistics chart at the end of this section for the number of each type of vaccine that was administered under each program in 2012s
TUBERCULOSIS (TB) CLINICS & SERVICES Nursing staff provided assessment, interview, screening, and treatment services for individuals diagnosed with active & latent tuberculosis. Screening tests for exposure to TB & HIV were performed. A total of 88 patients received services provided by our TB program. A TB Clinic with infectious disease physicians was held every 3rd Thursday of the month. A total of 88 patients received services.
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Purified Protein Derivative (PPD) testing, intake interviews, and referrals for chest x-rays and lab tests were provided on a daily basis for walk-ins and for scheduled appointments. New reactors and infected patients were HIV tested at the TB clinic. Various vaccines provided for uninsured or underinsured. Medications for treatment were distributed as required. Hospital visits for assessment of need were provided at the time of discharge. Home and work site visits for daily observed medication therapy were conducted for active TB patients.
2012 INFLUENZA VACCINATION CAMPAIGN VaxCare services for insured adults & children were provided from September thru March 2013. Two hundred four (204) individuals were vaccinated in 2012 in this program. Services required pre-verification of the insured. Pre-verification was time consuming, not always possible on location, and often unreliable. Financial reimbursement was disappointing despite VaxCare indicators that we were their #1 provider for verification/reimbursement in NJ. Ninety- one (91) individuals were vaccinated as daily walk-ins or as scheduled appointments. Flu shot clinics were held at Senior Centers in September. Centers visited included Luther Acres – 12 vaccinations, Kidston Towers – 31 vaccinations, The Vineland Senior Center – 34 vaccinations, and the YMCA – 27 vaccinations. Five hundred thirty-two (532) Abbott students at pre-schools were inoculated from October 1 thru March 2013. Two home immunizations were administered to homebound city residents. Eighty – two (82) City of Vineland employees were vaccinated at the Employee Health Fair, and while attending blood pressure clinics conducted at the Police Dept., Electric Distribution & Generation, and City Hall. Additional employees were also vaccinated on an individual basis at our office. Six (6) Cumberland Family Shelter residents (adults & children) received vaccines during an outbreak investigation in February. 29
Eleven (11) Homeless & uninsured individuals were vaccinated while attending the Vineland Homeless Survey Day at The First Presbyterian Church’s Soup Kitchen.
2012 EMERGENCY MEDICAL ASSISTANCE PROGRAM (Operational April 1, 2012 ~ December 31, 2012) Services provided by scheduled appointment, walk-in, or referral from other social service agencies.
COMMUNITY SUPPORT & HEALTH FAIRS Our nursing staff participated in five (5) Health Fairs throughout the year at the Veterans Memorial Home on February 2 for Black History Month, at City Hall for the employees’ health fair, at various blood pressure screening sites, and at the Cumberland County College for students interested in Public Health/Nursing as a profession.
COMMUNICABLE DISEASE INVESTIGATIONS FOR CASES RECEIVED AS A RESULT OF NJDOH MANDATORY REPORTING REQUIREMENTS Our staff conducted investigations for individual case reports and at facility outbreaks as communicable disease reports were received. •
Two (2) facility outbreaks of Norovirus in 2012.
•
Communicable disease investigations for individual case reports included o o o o o o o o
Giardiasis – one (1) Hepatitis A – one (1) Hepatitis B – thirty-seven (37) Hepatitis C – fifty-five (55) Mumps – one (1) Pertussis – ten (10) Salmonellosis – eight (8) Varicella – four (4) 30
ďƒź Our division investigated four (4) reported elevated blood lead levels to assist REHS inspectors in identifying the source(s) of lead exposure.
PARTICIPATION IN COMMUNITY SUPPORT, SERVICE COMMITTEES and PUBLIC HEALTH EDUCATION AND MEETINGS Healthy Mothers & Babies Regional Meetings NJ HIV Planning Group, Cumberland County & Atlantic Southern Regional Lead Prevention Council Cumberland County Human Services Advisory Council NJ. Public Health Nurses Assn. Public Health Nurse Summit Infectious Disease Summit Numerous web-ex trainings PH Strategic Planning Workshop & Meeting Communicable Disease Investigator Training All employees completed the required Emergency Management Institute Training Mandatory RN Training-COMMUNICABLE DISEASE INVESTIGATOR TRAINING COURSE
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INDIVIDUAL CLINICAL SERVICES
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Year: 2012
January
Feb
March
April
May
June
July
August
Sept
Oct
Nov
Dec
1. Immunization Program - # Children Vaccines for Children program (VFA) (Total: 230)
total: 24
< 12 months 1 – 4 yrs. 5 – 6 years 7 – 18 years
total: 7
4 16 1 3
Board of Ed Preschool Students (Total: 545)
total: 7
On site at school - Flu In Office - Flu
total: 14 0 5 0 2
------------
total: 9 2 8 2 2
-----------
total: 13 3 6 0 0
------------
total: 15
total: 11 8 2
1 2 ------------
total: 25
5
3
6 0 0
9
total: 25 4 8 5 8
0 3
total: 32
4 6 5 10
-------------- ------------
--------------
total: 51
DTaP Tdap Td HIB Polio MMR Varivax Hepatitis A Hepatitis B PCV 13 Rotavirus Meningococcal HPV Influenza (pediatric ages 6mos-35mos) Influenza (ages 36mos-18years) Influenza (Flumist) Influenza (Home Based for Invalids)
281 0
total: 18
total: 35
total: 58
total: 27
total: 37
total: 37
2
5
3
12
7
2 1 4 2 2 1 1
4 3 3 3 3 4 3 2
3 3 1 2 2 2 3 2
8 12 1 2 2 6 8 6 1
6 4 2 1 2 3 9 3
5 16 6
2 1
1 4
3
6 17
3 5
4 7
6 5
5 1 4 6 2 1 5 4 3
total: 85 8 1 1 6 9 6 5 2 4 7 2 1
total: 27 3 9 1 15
3 8 5 11
total: 281 total: 179 total: 78
0 7
# Vaccines administered by name (Total: 1180)
total: 28
5 9 3 15
total: 67 13 5 7 13 9 9 7 2 7 1 5 5 2
total: 379 6 5 1 5 6 1 5 5 2 6 2 5 1 1 11 5
10 85
177 2
total: 244
37 36
total: 127
8 7
3 3
5 3
7 7 6 8 7 5 4 4 7 6 63 240
2 3 3 5 6 3 4 2 2 6 2 51 149
3 4 1 1 2 1 3 3 1 1 2 47 50
7 39
10 42
6 48
2. Immunization Program - # Adults STD Clinic (total: 78) Office/out of office (total: 269)
# Vaccines administered by name (Total: 376)
total: 25
Tdap Hepatitis A/B Hepatitis A HPV Influenza (Adult 317 funds) Influenza (Vaxcare Program) Zostavax Pneumococcal Meningococcal MMR Varivax
total: 8
total: 12 2 6
8
total: 11 6 4
9 4 total: 13
1 9
5 5 total: 10
3 6 3
5 7 total: 12
4 5
7 4 total: 11
4 7
total: 109 2 7
1 1
17
1
1
total: 52
total: 58
3 10
3 8
33
1 23
57 3
total: 54 3 13 2 7 28
17
3 2
1
1
4 2 5 43
1 1
1 1
1 2
Home visits made for flu vaccine 3. Childhood Lead Poisoning Prevention Program Lead Testing - capillary done in office (uninsured only) Lead Investigations - home visits Lead Activities in Community (pres chool s /hea l th fa i rs )
1
1 2
12
15
0 0
1 10
1 1 Health fair
4. Blood Pressure Clinics (total 11) Luther Acres Senior Housing - #clinics Clients served
1 25
1 20
1 19
1 17
1 21
1 15
1 24
1 22
1 17
1 14
5. Communicable Disease Investigations Giardiasis Hepatitis A Hepatitis B Hepatitis C H. Influenzae Mumps Pertussis Salmonellosis Streptococcus Pneumoniae VISA Varicella Perinatal Hepatitis B
1 4 13
5 12
21
2 15 1
5 15
2
1
2 2 1
1 5 11
1 18
4 15
3 2
2
3 12
3 8
3 9
2 4
1
1 1
1
1 2
1 Total Investigations
18
1
17
23
35
21
25
19
27
2
1
2
1
22
1
17
14
14
7
6. School Audits a. Preschools
(all students audited)
ABC Learning Academy All Kids First All Kids First II Almond Road Preschool Bishop Shad Preschool Children's Choice Learning Center Christ the Good Shepherd Preschool Cradles to Crayons Cumberland Christian School Dallago Preschool DiBiase Preschool Early Learning Ellison School Golan Learning Center Golden Gate Academy Greater Deliverance Learning Center
49 240 60 64 7 24 48 5 18 234 88 30 58 104 20 19
Headstart III
Headstart II Impact Child Care Kings Kids Childcare Leuchter Preschool Little Lamb Preschool Tejeras Early Learning Center The Courtyard School Tiny Tots Preschool Weisman Children's Medical Daycare YMCA
b. Private Schools
62 95 54 13 210 88 98 89 102 26 65
#students/# audited
Bishop Schad Regional Creative Achievement Creative Achievement - Chestnut Cumberland Christian DCF Regional School Ellison School Pineland Learning Center Sacred Heart High School Vineland Mennonite School
c. Public Schools
259/60 24/24 31/31 356/80 162/91 154/154 29/29
#students/# audited
Barse Elementary School Cunningham Alternative School D'Ippolito Elementary School Durand Elementary School Johnstone Elementary School Landis Intermediate School Memorial Intermediate School Mennies Elementary School Petway Elementary School Rossi Intermediate School SUCCESS Sabater Elementary School Vineland Senior High School Vineland Public Charter School Wallace Middle School Winslow Elementary School
409/71 71/3 716/124 574/102 476/97 520/183 521/175 656/146 565/90 555/202 586/97 189/31 490/176 559/74
d. Total Audits done
12
27
9
# Childcare/Pre-K facilities operating
27 12 13 0 12 0 11 0 8 0
27 15 13 10 12 9 11 6 8 0
27 0 13 3 12 3 11 5 8 3
# Childcare/Pre-K facilities audited # Kindergarten facilities operating # Kindergarten facilities audited # Grade 1 facilities operating # Grade 1 facilities audited # Grade 6 facilities operating # Grade 6 facilities audited # High School facilities operating # High School facilities audited (transfer students)
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Vital Statistics The Office of Vital Statistics consists of a Registrar, Deputy Registrar and two Alternate Deputy Registrars. We verify that all records submitted to this office are accurate and complete and have developed procedures for obtaining prompt and accurate reports of births, marriages, and deaths. In 2012, we recorded 2,037 births, 747 deaths, and 418 marriages. In addition, this office issued 5,648 birth certificates, 1,630 death certificates, and 658 marriage certificates. 406 marriage license applications were taken and 196 corrections were submitted to the State.
37
38
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Emergency Medical Service Vineland’s EMS Division operates 3 ambulances 24 hours per day seven days per week. These rescue vehicles are strategically stationed for optimal response time throughout the City. During the 12 busiest hours of the day a fourth ambulance augments this response group. This power shift is tasked with locating to fill any voids created by the dispatch of ambulances, such that the second ambulance needed in a part of the city may be able to get to a call as fast as the first. In 2012 VEMS responded to more than 10,700 calls for service. Nearly 8,000 patients were transported to a hospital or landing zone. Vineland provides mutual aid services and receives mutual aid service from all of our surrounding communities. The City’s EMS system is the only organization to have twice been acknowledged as the Public EMS Provider of the Year by the NJ State Department of Health Office of Emergency Medical Services and the New Jersey EMS Council. The Division actively supports state and local emergency management and homeland security functions. EMS frequently partners with Police, Fire, Electric, Public Works, Board of Education and other entities to enhance public safety. Vineland EMS actively participates in the provision and growth of local medical services with the Inspira Health System. VEMS worked as a partner to achieve Inspira Medical Center Vineland’s status as a designated Chest Pain Center. EMS also participated in regular stroke council sessions. Each day the Inspira Medical Center’s paramedics and Vineland EMS Emergency Medical Technicians work together to handle potentially life threatening calls. Vineland’s EMS system was built to serve the people of Vineland. The analysis of system operations and growth has always had patient care as the primary focus. Expansions have happened strictly based upon need. If you are in need of emergency medical services anywhere in Vineland, Vineland EMS is here for YOU.
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