ANNUAL REPORT
centercenterFiscal Year 2016 20112ANNUAL REPORTFiscal Year Ending June 30, 20161000000Fiscal Year 2016 20112ANNUAL REPORTFiscal Year Ending June 30, 2016419100-333375006381757508875210 East Walnut Street, Nicholasville, KY 40356: (859) 885-4149210 East Walnut Street, Nicholasville, KY 40356: (859) 885-4149438150-323850Table of Contents00Table of Contents8667751699260Page 3 – Director’s MessagePage 4 – Financial ReportsPage 5 – Preventive Medical ServicesPage 9 – HANDSPage 10 – Administrative/Support ServicesPage 13 – Environmental ServicesPage 15 - Community Health ServicesPage 23 – Epidemiology Page 25 – PreparednessPage 26 – Board of Health330000Page 3 – Director’s MessagePage 4 – Financial ReportsPage 5 – Preventive Medical ServicesPage 9 – HANDSPage 10 – Administrative/Support ServicesPage 13 – Environmental ServicesPage 15 - Community Health ServicesPage 23 – Epidemiology Page 25 – PreparednessPage 26 – Board of Health349885134620Our MissionPromote, Protect, and Improve the Health and Wellness of our Community00Our MissionPromote, Protect, and Improve the Health and Wellness of our Community34956750003619500A Message from the Public Health Director Randy Gooch00A Message from the Public Health Director Randy GoochThe necessity for change is driven by our ambition of “Everyone reaching their maximum health potential”…our organizational vision. This is why the Jessamine County Health Department continuously endeavors to maximize the utilization of every resource to “Promote, Protect and Improve the Health and Wellness of our Community”…our organizational mission.Health status in our community and our state continues to drive our planning and efforts as a local health department. According to the “County Health Rankings”, a project of the Robert Woods Johnson Foundation, Jessamine County ranks 9th out of 120 counties for Health Outcomes and 20th for Health Factors. Health Outcomes is a measure of the length of life and quality of life including premature death, poor or fair health, poor physical health days, poor mental health days and low birth weight. Health Factors is a measure of health behaviors, clinical care, social and economic factors, and physical environment, which includes many specific areas. All information can be viewed at . While it’s good Jessamine County ranks high in the state of Kentucky, the bad news is Kentucky ranks 44 of 50 states in overall health status according to America’s Health Rankings ( ). Improvement of these rankings is a great challenge but with this comes opportunity for improving the health of our community in a positive way.The core functions of public health are Assessment, Policy Development and Assurance. This provides a continuous loop of identifying needs, developing strategies and policies to meet those needs and making sure we are carrying them out in a way which positively impacts the needs identified. The Community Health Assessment and Improvement Plan along with our Strategic Plan are evidence of these activities. You may review these documents on our website at under About Us.Our organization has made application to achieve national public health accreditation of which we hope to attain in the first quarter of 2017. This process has helped us grow in areas such as quality improvement, performance management, community partnerships, workforce development, policy development and many others which will assure the community we are serving their health interest in the most effective and efficient manner possible. The Jessamine County Health Department remains committed to working diligently for the protection and improvement of our community’s health. Our people are our greatest resource and I’m proud to say we have a team committed in working together for the success of our organization and the community. Thanks for allowing us to serve you!-263525-238760Revenue/Expense/Fund Balance Summary Analysis00Revenue/Expense/Fund Balance Summary Analysis391477521907500-198256-285750PREVENTIVE MEDICAL SERVICES00PREVENTIVE MEDICAL SERVICESOur clinic team, consisting of professionals including an APRN, RN, LPN, Registered Dietitians, and Lactation Specialists continue to provide excellent patient care, education and counseling services in a wide array of preventive programs. These programs consist of Immunizations, Well Child Exams, Dental Varnishing, Prenatal, Family Planning, Cancer Screening, Medical Nutrition Therapy, WIC, as well as Tuberculosis and Sexually Transmitted Disease services. Below is a summary of the total patients and services provided by these programs: Karen Fallon, MPH Clinic Services ManagerPlease visit to learn more about the many services we provide.Clinic Visits by Program19050019050000Dental1,496 Pediatric3,020 Family Planning404 Prenatal106 WIC7,431 Nutrition28 Tuberculosis594 STD295 Adult Health582 Cancer Screening142 Total Clinic Visits14,098 Patients by Program209550000Dental787 Pediatric1,038 Family Planning437 Prenatal21 WIC2,102 Nutrition7 Tuberculosis272 STD226 Adult Health526 Cancer Screening178 Total Unduplicated Patients: 4,029-103777-266065PREVENTIVE MEDICAL SERVICES (Continued)00PREVENTIVE MEDICAL SERVICES (Continued)PROGRAMS OF INTERESTWIC and the Breastfeeding Peer Counselor Program: The Women Infants and Children (WIC) program has been going strong for over 40 years. Since its beginning in 1974, the WIC Program has earned the reputation of being one of the most successful Federally-funded nutrition programs in the United States. Collective findings of studies, reviews and reports demonstrate that the WIC Program is cost effective in protecting or improving the health/nutritional status of low-income women, infants and children. During the 2014/2015 fiscal year, the Jessamine County Breastfeeding Peer Counselor Program continued to promote and support breastfeeding in our community. This program is designed to provide mother to mother (paraprofessional) breastfeeding support and basic breastfeeding education to WIC Program mothers who are pregnant or breastfeeding. Mother-to-mother support has proven to be one of the most successful approaches to encourage mothers to breastfeed their babies. WIC Peer Counselors serve as role models by breastfeeding their babies and talking about their experience. They receive training on breastfeeding basics and counseling skills. Our Peer Counselors work under the direction and supervision of a Certified Lactation Counselor. 18535658572500Immunization Program: The Jessamine County Health Department in conjunction with the Kentucky Immunization Program work to provide services aimed at preventing and reducing the risk and incidence of vaccine-preventable diseases. According to a report from the Centers for Disease Control and Prevention, vaccines given through the Vaccines for Children (VFC) program over the past two decades will prevent 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes. The Kentucky Immunization Program (KIP) conducts an Annual School and Childcare ImmunizationSurvey to assess vaccine coverage of school-age children in Kentucky. The survey targets all Kentucky kindergarten and sixth grade students and the results of the 2014-15 survey were released in June 2016. The Healthy People 2020 vaccination goals for school-aged children are as follows: Kindergarten: ? Greater than 95% for 4+ DTaP, 3+ Polio, 3+ HepB, 2 MMR, and 2 Varicella; Sixth Grade: ? Greater than 95% for 3+ HepB and 2 MMR, ? Greater than 90% for 2 Varicella, and ? Greater than 80% for 1 Tdap and 1 MCV The Jessamine County reports shown below indicates that we have some work to do to target childhood vaccination improvement efforts. Ongoing education to minimize exemptions and reach the 2020 goal of greater than 95% vaccination coverage will protect our community from vaccine preventable disease (VPD) outbreaks such as Pertussis (whooping cough), measles and mumps. *Kentucky Annual School Immunization Survey, 2014-2015Age-Specific Group: Vaccines and DosesJessamine CountyCounty RankKYAverageUSAverage*,?HP 2020Goal??KindergartenDosesAntigen%%%95.0%4+DTaP91.29194.495.095.0%3+Polio94.47094.7-----95.0%3+Hep B91.68894.1-----95.0%2MMR93.26592.794.795.0%2Varicella91.67492.393.395.0%Sixth Grade-5715762000DosesAntigen%%%% Varies1Tdap92.55184.586.0 (±0.9)(80%) Met1MCV93.04083.177.8 (±1.1)(80%) Met3+Hep B93.211397.4-----(95%) Not Met2MMR96.09997.791.8 (±0.8)(95%) Met2Varicella94.64288.878.5 (±1.3)(90%) MetPercentage of Certificates and Exemptions on Filefor Kindergarten and Sixth Grade in Jessamine CountyKindergartenSixth GradeCurrent Certificate96.2%94.0%Medical Exemption0%0.5%Religious Exemption1.9%1.9%No Certificate on File1.9%3.5%Lead Screening: 443865025654000Lead exposure can cause serious harm, particularly to young children and pregnant women. Lead poisoning can affect brain development leading to learning disabilities in children and increase the risk of miscarriage, birth defects and anemia. Lead-based paint and lead contaminated dust in older buildings are the most common sources of lead poisoning in children. Other sources of lead poisoning are contaminated water, soil, air and some toys and cosmetics. Lead can enter the body through the mouth (eating or breathing) or through the skin (by way of a cut or scrape).The local health department provides free or low-cost lead screening for children up to six years old. Case management and follow-up services for those with elevated blood lead levels are also available. All children under the age of six should be screened for lead poisoning. Children should be tested at age 9-12 months and again at 24 months. Children who are at higher risk may need to be tested more frequently. CARE Collaborative Grant In 2015, JCHD applied for the CARE Collaborative Grant for FY 2016 and was awarded $15,000. CARE is an acronym for Cardiovascular Assessment, Risk Reduction, and Education. The CARE Collaborative was initiated by the Kentucky Heart Disease and Stroke Prevention Task Force. It is a blood pressure awareness program for men and women in Kentucky age 18 and above. The CARE Collaborative program uses a blood pressure record tool which focuses on an educational encounter using green (normal), yellow (caution), and red (warning) zones. JCHD plans on partnering with the Jessamine County HOSA group and other community partners to implement this program at a variety of venues across the county. Humana Vitality Screenings and Flu Prevention: During the 2015 fiscal year our clinical staff teamed up with Health Education and Worksite Wellness to provide flu shots and Humana Vitality Screenings at various offsite locations around the county. Syringe Exchange Program (SEP): Currently, the SEP in Jessamine County is implemented through our clinic during specified hours. Our SEP Coordinator attended a week long National Harm Reduction Training in Austin, Indiana in March 2016 in readiness for our April 4, 2016 opening. Five additional JCHD team members received Harm Reduction Training in July, 2016. Participants in SEP are not only offered needle exchange services but also receive comprehensive harm reduction information and have access to on the spot rapid HIV and Hepatitis C testing. A Certified Drug and Alcohol Counselor is available onsite to participants during SEP hours. To date, the program has served over 50 patients. -16510-448310HANDS00HANDSThe Health Access Nurturing Development Services (HANDS Program) is a home visitation organization for prenatal parent, and for families with newborn babies. Since July 1, 2015 we are pleased to offer services to families who have other children, any time during the prenatal period until the baby is 90 days old. The services are free of charge and voluntary. Our HANDS Program includes Parent Visitors, Family Support Workers, and two registered nurses to provide support to parents. We include available community resources and learning opportunities covering healthy pregnancies, babies, and promoting strong, capable families. We discuss how to create a safe, nurturing, and healthy home for the family. Statistically, participation in the HANDS Program results in fewer premature births, fewer low birth–weight babies, and fewer developmental delays.Polly Brandenburg, RN HANDS CoordinatorWe are pleased to announce Emily Cravens, Parent Visitor/Family Support Worker, Family Support Worker, has joined our staff this year. Robbie Shumate, Family Support Worker, has also joined our team. Kailah Campbell remains with HANDS as a Family Support Worker. Jean Beaty, RN, continues to help with maintaining our quarterly home visitation piece of the HANDS Program. Amanda Summersett remains working with HANDS as Parent Visitor/Family Support Worker, part-time. Polly S. Brandenburg, RN Supervisor/Parent Visitor/Coordinator, continues to lead the HANDS Program in Jessamine County. We continue to partner with Operation Sharing, a program that provides various types of donated items to our HANDS’ families. We also continue to work with Jessamine Early Learning Village in a combined effort to support various activities that promote families in our community. We are continuing with our reading initiative by accessing various ways we can purchase hard-back books and provide them to our families. We very much appreciate the various schools that have invited us to set up tables with information regarding the HANDS Program, as well as various services offered by Jessamine County Health Department. We have had several very successful HANDS sponsored playgroups for our families this year at the Jessamine County Health Department. This summer we had a “luau” that families and staff alike enjoyed. We have already begun to plan our Fall and Christmas playgroups. We also have several families that will be graduating.This fiscal year it was our honor to serve 229 families in Jessamine County. The number of families continues to grow weekly. We continue to strive to find new ways to support our families such as partnering with Cribs for Kids, and attending various trainings to help us be the best program possible for our community. This fiscal year, the HANDS Program statewide have attained the status of being an evidenced- based program which puts us in better standing to apply for and receive government grants so we can better serve our community. It is our continued goal to reach as many families within Jessamine County as possible and offer them the HANDS Program. We found it to be true; every parent needs a second pair of hands.-104775-200025Administrative & Support Services00Administrative & Support ServicesThe Administrative Services Department is charged with financial and personnel, which includes accounts payables, account receivable, purchasing, payroll, personnel, etc. Last year administration began printing account payable checks by the use of a laser printer. It was discovered that by using this process that it was the most efficient use of administrative time. We found that the time spent to print account payable check had decrease significantly from 13 hours per year to less than 3 hours this year. Joanne Morgan Director of Administrative ServicesThis year we made an addition to the administrative team of a full time Account Clerk III. Now we closely monitor collection and billing of all Medicaid MCO’s, Medicare, private insurances, private pays, and Humana Vitality. We promptly investigate and immediately process any denied or rejected insurance claims for medical and dental services received from Jessamine County Health Department. All private pay patient invoices are sent out every quarter for collection of payment for services rendered. Trainings - As part of Workforce Development Training this past year along with our Accreditation Coordinator’s leadership, each one of us personally developed training plans for professional development and to build competency in public health areas; each plan was reviewed and approved by our supervisor. We have received several sessions for technology training in Excel and before the start-up of the Syringe Exchange Program we attended Naloxone Training and participated in Tabletop Exercise for Jessamine County Health Department COOP a Public Health preparedness program.Our Support team continues to provide the following services:Client registration and check out,Cashier services for collection of fees,Processing of medical records releases,Issuing Immunization Certification using the Immunization Registry,Telephone and fax operations andManage and maintain medical records.Due to the growth in some of our Health Department Programs, there are team members that are currently sharing offices together. With the shortage of office space we have been working diligently to clear out our medical records storage room. We are in hopes into converting this space into six to eight modular office spaces for staff members. This year we contracted with a storage facility that will store our old paper records. We are using the Kentucky State Archives and Records Commission, Records Retention Schedule for archiving and destroying our paper records. To date, we have stored Birth and Death Certificates dating back to 1911, patient medical records, using the retention schedule formula, and health department administrative records. We continue to work diligently to store all our paper records with a date of destruction assigned to the box of records stored. We are in hopes of beginning an Electronic Health Records (EHR) in the near future, which will alleviate the need for paper storage of patient medical records.Our Support team continues to perform presumptive eligibility on women who present with a positive pregnancy test, using the KY Health Benefits Exchange system. We strive to assure that all pregnant women receive prenatal care. The Health Department continues to use the Same Day Scheduling system to decrease the high rates of no show clinic appointments. Two team members are collaborating together to develop a flow chart of the process from scheduling the patients to compiling data in a spreadsheet what shows results daily of the number of patients scheduled with each provider, the percentage of patients seen per provider, and well as the productivity percentage for the clinic. Due to WIC requirements, we do offer per-scheduled appointments for WIC cardholders who work or are in school. Below are the Did Not Keep Appointment chart that compares fiscal year 2015 to 2016 and a chart for only fiscal year 2016 showing month by month appointments not kept.300037589535002014-20152015-2016July12%18%August10%15%September7%18%October6%17%November6%16%December5%16%January3%17%February2%17%-17926059588500March4%22%April14%21%May15%18%June17%17%Vital StatisticsOur Vital Statistics Registrar is a representative for the Office of Vital Statistics and follows all procedures and practices established by the State Registrar. The registrar appoints deputy registrars, provides vital statistics forms to public and provides instructions on how to complete and where to mail the forms. She also, reviews and edits birth certificates, stillborn certificates, declarations of paternity for completeness and accuracy before acceptance. All home births, paternity acknowledgment and birth certificate applications are submitted to the State for processing. Permits for dis-interments and re-interments within the same cemetery are also issued by the Registrar. This year our Register reports that Jessamine County has approximately 308 deaths and 588 births, of which 5 were home births. She also, assisted the public with completing and notarizing the approximately 5 Paternity Affidavits. See comparison chart for FY15-FY16.-36195-171450Environmental00EnvironmentalThe Jessamine County Health Department Environmental staff works hard to protect the public’s health by enforcing of Kentucky Laws that govern concerns such as food and water safety. Environmentalists inspect restaurants to help ensure that the food the public eats is safe. We also inspect new and existing septic systems to help protect ground water. Overall, Environmentalists are engaged in over 30 programs to help protect the safety of the community.-13906518415Lisa Bolton, RS Environmental Services Manager00Lisa Bolton, RS Environmental Services ManagerEnvironmentalist performed 471 food service related inspections. There was a decrease of 11 in the number of permitted food establishments. This past year only four new food service establishments opened versus 14 last year. The average food service inspection score this year was 95.7%. Our health inspectors teach quarterly Food Manager Classes. This year 39 food managers were trained during an in-house course. An online Food Handler course is available. Over 800 food service workers were trained through the online Food Handler course. Schools, public swimming pools, hotels and motels, mobile home parks, tattoo parlors, piercing studios, and youth camps are inspected by the Health Department. Environmentalists performed 97 of these types of inspections. This number is down 8 inspections from last year. There were also 40 commercial plans reviewed for new and remodeled construction. This number is down 4 from last year. General Sanitation programs include nuisance complaints, bed bugs, water samples, animal bites, mold, and methamphetamine. 249 General Sanitation inspections, complaints and activities were recorded. This number is down 19 inspections from last year. Of all activities 159 of these activities were animal bite related. This number is down 38 activities from last year. When and animal bites, it is our job to make sure that the animal does not have rabies and that domestic animals are vaccinated against rabies, starting at four months of age. To offer low cost rabies vaccinations, environmentalists along with local veterinarians held 2 rabies clinics during the month of June. Approximately 600 pets were vaccinated against rabies at these clinics. Environmentalist performed 87 Site Evaluations for new construction. This number is down 15 site evaluations from the previous year. 103 Septic Permits were written for residential and commercial properties. This number is the same as last year. Other inspections include septic alterations and additions due to home remodeling or failing septic systems. Septic tank cleaning vehicles are also inspected. With the emergence of Zika, the importance of mosquito control and prevention was a top priority this summer. This summer we worked with the Department of Agriculture to spray 45 properties to help control mosquitoes in Jessamine County. This number is more than twice as large as last year. Mosquito spraying is by request and occurs from June to September. Radon test kits were distributed to homeowners wishing to test their homes for radon gas. This year we distributed 58 test kits, 6 more than last year. Anyone wishing to have their home tested for radon should contact our office for information and a short-term radon test kit. The cost is seven dollars.GIS GrantThis year we received a 14K grant for the implementation of GIS. We planned a project using the years of radon data that we have recorded from the test kits sold through the Health Department. We used grant funds to purchase software and train several employees on the system. We completed the project by creating a map which plots radon test results in Jessamine County. 771525142875004130040228600-47625-295275Community Health00Community HealthFiscal Year 2015/2016 was a very productive year for the Community Health Division at the Jessamine County Health Department. Through the ever changing and growing programs, we continue to focus on our mission to promote, protect, and improve the Health and Wellness of our community. Below you will find a brief summary of the many activities and accomplishments made by our Health Education Staff throughout the FY 2015/2016.3924300160655Andrea Brown, MPHPublic Health Services Manager00Andrea Brown, MPHPublic Health Services ManagerSchool Health Education Initiatives: Teens Against Tobacco Use Partnerships with the schools enabled us to continue to provide Teens Against Tobacco Use (TATU), a teen mentoring tobacco prevention education program, to both East Jessamine Middle School (EJMS) and West Jessamine Middle School (WJMS) sixth grade students. This program reached ~320 unduplicated students at both EJMS and WJMS. During FY 15/16, the TATU program received an overhaul to revise the outdated pre/post-test evaluations. See Quality Improvement to learn more. Abstinence Education: Through on-going efforts to prevent teen pregnancy, JCHD received a continuation Title V Abstinence Education grant. This grant funds two research-based, age appropriate abstinence only education curriculums to be taught in middle school. In 2015/2016 a new curriculum was use to replace the previous curriculum Postponing Sexual Involvement. Positive Potential is now being taught to 7th graders students at EJMS. This curriculum is presented as a youth development program focusing on the five whole parts of the body, media, STD’s, goal setting, and creating a positive legacy. Choosing the Best is the curriculum taught to 8th grade students. This program focuses more on consequences to early onset of sexual activity discussing, alcohol and other drugs, STD’s, effects of teen pregnancy, and HIV. These programs combined reached ~70 unduplicated students in the 7th and 8th grade at EJMS and prehensive Sexuality Education: In FY 2015/2016, JCHD received the Personal Responsibility Education Program (PREP) grant which afforded us the opportunity to teach Reducing the Risk (RTR), science-based age-appropriate comprehensive sexuality education curriculum to high school students attending The Providence School, an alternative high school in Jessamine County that works with at-risk students. Through this program, we reached 30 at-risk high school students. Violence Prevention: 4238625612457500In 2015/2016 through the Maternal and Child Health program, JCHD received funding to initiate a new violence/bully prevention program. We elected to pilot this program at EJMS for the first year. This program, developed through the Mendez Foundation called Too Good for Violence, is a 10-lesson curriculum to help prevent violence and bullying in schools. The community health team met with EJMS curriculum specialist to review the program and decided that 6th grade Science class was the appropriate setting for the program. Every 6th grader takes Science all year so doing in that classroom would allow all students to be exposed to the program. Due to time constraints, the program did not launch until April 2016 allowing only three lessons to be taught before the school year was over. The Community Health Team collaborated with the EJHS to recruit and train High School teens to present the curriculum material as a peer-lead program. Based on the posttest results 76% of the students correctly identified what violence behavior is compared to 73% on the pretest. Based on the posttest alone, 87% of the students say that bullying should not be tolerated and 90% say that if they were to witness a bullying situation they would report it to a responsible adult. This program will be expanded to six lessons at EJMS and WJMS next year. 3267075120015000Public Health Dental Hygiene Program: 44672253695700-1238251634490For the past two years, The Jessamine County Health Department received a $160,000 Public Health Dental Hygienist Program grant to provide preventative dental services in the Jessamine County and Mercer County school system to qualifying students that have not seen a dentist in a year or more. In FY 15/16, JCHD serviced 787 students between the Jessamine and Mercer school system. Through our examinations, approximately 50% of the students serviced had dental decay. Through the grant funding, JCHD was able to purchase a van for the transportation of the dental equipment to and from each school. JCHD collaborated with the a Jessamine Career and Technology Center’s graphic design student to design a wrap for the van to highlight not only the dental program but all the public health prevention programs JCHD munity Health Education Initiatives:Safe Communities: -123825587692500During the summer of 2015, Jessamine County applied for a National Safe Communities Designation through Safe Communities America, part of the National Safety Council and two JCHD staff was able to attend the annual Safe Communities Meeting in Chicago in August. In September, the Safe Communities America Team conducted a site visit, and their reviewers met with the community partners and had the opportunity to see many of the excellent programs that Jessamine County offers to improve local safety and reduce injuries. The National Safety Council designated Jessamine County as a Safe Community and the Coalition held an official accreditation ceremony on February 5, 2016 at West Jessamine High School to celebrate the achievement. Three workgroups, created to focus on areas of high injury or death, are: Drug Overdose and Suicide, Motor Vehicle Safety and Emergency Preparedness, and Workplace Safety and Adult Falls. Drug Overdose and Suicide:The Drug Overdose and Suicide workgroup, coordinated by the Jessamine County Agency for Substance Abuse Policy (ASAP) group, is an integral part to many JCHD programs. Our partnership with this group allows for networking with other community groups and leaders, while collaborating on programming pertinent to our community needs with regard to prevention, treatment and/or enforcement of substance use/abuse.? ASAP has supported local policies relating to Responsible Beverage Server Training; Keg Ordinance; Social Host Ordinance; Smoke Free School Campuses; and drug trends. ASAP has supported community presentations, school programming, and our own tobacco cessation efforts. This partnership has and continues to allow JCHD to work to tackle substance use issues that impact public health, most recently the heroin/opiate epidemic, as well as the fall-out that goes along with such an epidemic; increased burden on law enforcement & first responders, court system, jails, public health, etc. In recent years, Jessamine County witnessed an increase in heroin usage, mainly due to prescription opiates and controlled substances becoming more difficult for drug abusers to obtain.In the fall of 2015, with the full support of the JC ASAP Board, Jessamine County Health Department (JCHD) Director, Randy Gooch, began an educational campaign to inform the local elected officials and community leaders about the benefits of a Syringe Access/Exchange Program (SAEP). He shared vital information concerning the importance of SAEP, such as: reduction in the number of needles discarded in our community; reduction in the spread of disease due to needle sharing; reducing the risk to law enforcement if conducting a search (because we would offer retractable syringes); and also act as a point of intervention by offering an on-site drug addiction counselor if a participant was engaged and ready for treatment. -123825422402000Due to those very reasons, JCHD successfully completed the steps required by Senate Bill 192 to implement a comprehensive SAEP. The first step involved the JCHD Board of Health signing a resolution in full support of development and implementation of an SAEP; that was achieved in December 2015. That resolution enabled Mr. Gooch to present the case before the City of Nicholasville Commission and the Jessamine County Fiscal Court. In January 2016, JCHD received approval through votes from both the City and County to initiate and launch a comprehensive Syringe Access/Exchange Program. In March of 2016, JCHD staff directly involved with the SAEP attended the National Harm Reduction training in Austin, Indiana (the hub of a drug-fueled HIV outbreak of 153 confirmed cases, directly linked to needle sharing in 2015). The JCHD was committed to learning the barriers and successes to SAEPs already in use; training and shadowing allowed our staff to understand all components and functions of a SAEP, so JCHD staff furthered their education by observing in both the Lexington-Fayette County and the Louisville Metro SAEPs. In addition, JCHD hosted Naloxone training for all JCHD staff to enable them to recognize signs/symptoms of an overdose and how to administer the life-saving drug. With those educational initiatives completed, JCHD launched the SAEP on April 4, 2016. Motor Vehicle Safety and Emergency PreparednessThis past year, our motor vehicle safety and preparedness workgroup planned a countywide, safe driving campaign and PSA competition with local high school students.? Student council members promoted the PSA competition through the school, and students were asked to create picture or video PSAs discouraging from poor driving habits, including distraction and substance abuse. Other activities involved with the campaign included students signing the 5-to-Drive pledge, high school students with signage against distracted driving lined up at each of the schools in the district during the month encouraging parents and student drivers not to use their phones while driving. Winning PSAWorkplace Safety and Adult Falls355282552959000The workplace safety and adult falls group has worked to create a workplace safety team, comprised of local safety professionals who will offer their time to provide safety inspections at worksites that do not have dedicated safety professionals and homes in the community.? The goal of the safety team is to identify risks and prevent falls/injuries in both the workplace and home setting.? The group also worked on a proposal for funding and offering of CPR/First aid certification for high school students.Tobacco Cessation: Tobacco Cessation changed in FY 15/16. The JCHD expanded cessation programming to include the American Lung Association’s Freedom from Smoking (FFS) Program, in addition to the already active Cooper-Clayton Tobacco Cessation Program and the Kentucky Quitline. The FFS program was recognized by the State Tobacco Program as a promising practice and was now encouraged for all LHDs to utilize this program in lieu of the Cooper-Clayton program. The Jessamine County Tobacco Coordinator attended this training in October of 2015 with plans to launch this program in FY 2017. In the interim, we continued to provide Cooper-Clayton Cessation classes through use of Jessamine County ASAP funds, and referred clients to the Quitline. In FY 2015, we had 24 Jessamine County residents utilize the Quitline services and in FY 2016, that number increased to 38 Jessamine County residents. The Cooper-Clayton numbers for both registered and comparison graduates are seen below. Exercise Programs: Strong Women is designed as an osteoporosis prevention exercise program that is evidence-based and targeted to midlife and older women to help prevent and reduce injuries associated with osteoporosis. The JCHD Strong Women classes average 15 participants/class and clocking ~ 50 physical activity contact hours per year for this program. JCHD has a certified Strong Women instructor on staff and offers three 8-week sessions free annually. Through the Arthritis Foundation, the Jessamine County Health Department offers a program called Exercise with Ease. This program of gentle exercise and movement was developed for the living longer population. JCHD has a certified Exercise with Ease instructor and provided three 8-week sessions free each year to the community. The JCHD Exercise with Ease classes average approximately 20 participants/class and clocks 60 physical activity contact hours per year for this program. 46291504886325Diabetes Education: Diabetes is one of the most common, costly, and preventable chronic diseases among adults today. To help people manage their diabetes, JCHD is now offering free Diabetes Self-Management Classes. With the assistance of a Certified Diabetes Educator, people with diabetes can participate in a free 4 hour learning session that will teach them the skills they need to eat healthy, learn about managing high and low blood sugars, medications, foot care, and physical activity. In FY 2015/2016 JCHD had 19 participants in this program. Worksite Wellness: The worksite wellness coordinator works with businesses in Jessamine County who are interested in any type of worksite wellness activity, from lunch and learns to policy development, or wellness challenges. The JCHD wellness coordinator provided a lunch and learn at the September Jessamine County Chamber of Commerce monthly luncheon on the benefits of worksite wellness, and writes wellness Tuesday Tidbits in the Jessamine County Chamber of Commerce’s weekly newsletter.During FY15-16, the wellness coordinator was responsible for coordinating Humana Vitality wellness checks for local businesses that are part of the Kentucky Employee’s Health Plan (KEHP) in both the spring and fall. The KEHP is the state insurance and requires that members of its LivingWell Health Insurance Plans complete an online health risk assessment or a “Vitality check” (biometric screening) in the springtime. This year, Franklin County Health Department invited JCHD to collaborate with their vitality team to provide vitality checks at some of their larger sites, and between those sites, Jessamine and Madison County, JCHD staff provided 1010 Humana Vitality checks (nearly double the previous year) at 38 different locations. The vitality checks allow members to receive a biometric screening, which includes a cholesterol panel, blood sugar, blood pressure, waist circumference measurement and BMI calculation, and aims to encourage members to know their numbers and ideally alert them to any issues that might be present, such as elevated blood pressure or cholesterol, and refer them to follow-up with their physician.In the fall, vitality checks were partnered with on-site flu shots at these KEHP sites, and also offered to other local businesses. JCHD partnered with 18 employers (including Jessamine County Schools) to provide on-site flu vaccinations to employees. With flu season, businesses lose millions each year because their employees become ill and employers can save an estimated $46-95 in medical costs per vaccinated employee when they host a flu vaccination program prior to December. FY 15/16 JCHD administered 632 vaccines, which is nearly 1/3 more than the previous FY.Another worksite program that JCHD offers to the community is the Diabetes Prevention Program (DPP), a CDC program targeted for individuals who are at high risk for developing Type 2 Diabetes, or those who have prediabetes. Our worksite wellness coordinator is a trained DPP facilitator and goes on-site to local businesses to offer the program. The class is a yearlong program, meeting weekly for 16 weeks, after that period, at least once a month. This year, two rounds of the class have been offered at worksites, one during lunchtime, and the other after regular business hours, for convenience for employees. This program is reimbursable through Anthem BC/BS at $429/person after the participants attend the first four initial classes. Since the inception of this program, we have had 18 participants in this program. Recreation Committee: This year the Recreation Committee focused mostly on the development of a website that would lead folks to hiking/walking/biking trails, boating/kayaking, horseback riding locations, etc… The committee took to the trails in Jessamine County to gather as much information as possible for the website. The website highlights the trails location with directions, parking options, terrain, distances, landmarks, and difficulty level. One of the committee volunteers, with a web development background, developed the website and took some amazing pictures to include. Once the website went live, it received over 5000 hits. Currently the website is down and the Recreation Committee is looking for resources to fund the development and hosting piece. Quality Improvement:In the fall semester of 2015, community health staff assessed the effectiveness of our TATU evaluation. Although we witnessed increases in knowledge gained and behaviors changed on some questions, we also noticed others decreased. Therefore, the Community Health team initiated a quality improvement project to identify the root cause. Utilizing the PDCA cycle, it was determined that the assessment questions were on average at an 8.5 grade reading level, which alerted staff that the assessments may have been above student comprehension. Our team reformatted the questions to a 6.3 grade reading level for use in the spring semester. Based on spring semester results, the new pre/posts-test questions accurately captured knowledge gained and behavior change. We will continue to evaluate the trends in student responses as lessons are altered for program effectiveness. Kentucky Colon Cancer Screening Grant: Jessamine County ranks among one of the highest counties in KY with deaths due to colon cancer. Because of the success of our first funding cycle, JCHD received a second round of funding to continue and expand on colorectal cancer screenings for 2014-2016. In May 2014, JCHD was awarded a 2-year grant totaling $69,625 through the KY Colon Cancer Screening Program to continue a colon cancer-screening program for qualifying 50-64 year olds in Jessamine County. Collaborating with the local Refuge Ministries Clinic, during FY 15/16 both agencies combined provided 11 FIT test kits and 4 colonoscopies to qualifying individuals. While this was a decline from years past, it was not a unique problem to JCHD, many grant recipients found that due to the Affordable Care Act, fewer patients are eligible for the program and those that do qualify are usually referred to a KYNECTor (to enroll in an affordable insurance plan). We expect a further decline in numbers and will work with the state to review the program and how we can further reach those in need. Through our partnerships with Colorectal Surgical and Gastroenterology Associates and Kentucky Cancer Program, we are able to provide more screenings to Jessamine County residents. Cribs for KidsIn 2015, Jessamine County was the recipient of the Maternal and Child Health Program funds to support the Cribs for Kids program; an initiative to provide safe sleep environments for qualifying newborns. The impetus for this effort came from a study published by the Centers for Disease Control and Prevention in 2015 where they found that “each year, in the United States, there are about 3500 Sudden Unexpected Infant Deaths” (). The breakdown of causes is documented below, with ~25% of those deaths caused by Accidental Suffocation and Strangulation in Bed. The Cribs for Kids program was developed to prevent accidental deaths caused by unsafe sleep environments through education about safe sleep practices and providing a bed to qualifying families in need. Funds received through the Maternal and Child Health Program enabled JCHD to purchase portable cribs to disperse to Jessamine County Residents in need of a safe place for their infant/baby to sleep. JCHD has partnered with the National Cribs for Kids Program, HANDS and Family Resource/Youth Service Centers to provide (at no charge) cribs with education about Safe Sleep habits to qualifying families. Through this program, we are able to work with the families to educate them on the standards recognized by the American Academy of Pediatrics to decrease the risk of SIDS and provide them with a crib. After receipt of the crib, we follow up with the families one month later and a JCHD employee reinforces those recommended Safe Sleep practices. In FY 15/16, JCHD distributed 18 cribs to qualifying families. We applied for funding in FY 16/17; additionally, community health educators are actively seeking community partners to provide matching funds to continue expand and provide long-term sustainability to the Cribs for Kids Program in Jessamine County. The JCHD Health Education staff is very fortunate to have such valuable partnerships that allow us to continue to provide and expand our programming for our residents. Many of these relationships/partnerships have been established through our memberships on boards and councils such as JC School Family Resource Center Advisory Councils, JC YMCA Board, JC ASAP Board, Jessamine County Parks and Recreation, JC Safe Communities and on a state level, Kentucky Public Health Association and Kentucky Youth Health Network. Through these strong partnerships, JCHD continues to provide and host annual events to bring health education awareness to the community. Some of these events include Jessamine County Health Screening Day, Fall Festivals for the JC School System, hand-washing and hygiene education and demonstrations to pre-school and elementary school aged children and many more. -104775-342900Epidemiology00EpidemiologyThe Epidemiology Program provides surveillance and response to communicable diseases for our community. Although preparedness budgets have experienced significant cuts, the Jessamine County Health Department is blessed to receive additional funding to house a Regional Epidemiologist who provides support to seven other counties. The Regional Epidemiologist continues to provide training to our new employees and healthcare partners on the state’s web-based infectious disease reporting system. In addition, JCHD has a multi-disciplinary group of individuals who are trained Epidemiology Rapid Response Team (ERRT) members. This team, under the direction of the Regional Epidemiologist, can provide immediate, comprehensive response to reports of disease outbreaks or other health threats to the community.Rudrani (Ronnie) Ghosh, MBBS, MPH Regional EpidemiologistThe Epidemiology program has worked to strengthen the regions relationship between the counties by holding meetings that involved local representatives from each of the 8 counties served. It is important that we do exercises as a region so that we are prepared for large events should we need to rely on our relationships with other county officials. Counties come together monthly for a regional hospital preparedness meeting to discuss current disease concerns. The epidemiology program has also implemented a trending data output that keeps directors and local epidemiology support knowledgeable about diseases being seen in the community; this information is updated and distributed on a monthly basis. The regional epidemiologist and regional preparedness coordinator have also participated in and organized several meetings regarding emerging infectious diseases such as Zika and other various infectious diseases. The Epi Rapid Response team along with the preparedness coordinator work together to ensure that policies and healthy practices are followed and the community is kept up to date and informed about information concerning communicable diseases.Epidemiology Office also investigated respiratory outbreaks (KY15-1610 and KY 16-081) in long term Care institutions.-219075-47625000Jessamine County Health Department held their annual Rabies Clinic on the 11th and 25th of June, 2016Along with taking care of 323 pets, Epidemiology, Preparedness, and Environmental staff took this opportunity to disseminate and distribute Zika information and steps to be taken for mosquito prevention. Information was available in English and Spanish to meet the needs of Jessamine County community members.-104775-333375Epidemiology (Continued)00Epidemiology (Continued)Disease ConditionsFY2016 Jessamine Case CountFY2016 Jessamine Case rate per 100,000FY2015 KY Case CountyFY KY2015 Case rate per 100,000DifferenceCampylobacteriosis47.8703838.6780.808Cryptosporidiosis35.900561.269-4.631Group A Streptococcus, invasive11.960300.680-1.280Hepatitis B virus infection, Chronic23.930170.385-3.545Histoplasmosis11.960420.952-1.008Influenza, human isolates1427.550108724.629-2.921Legionellosis11.960992.2430.283Listeriosis11.96010.023-1.937Neisseria meningitidis, invasive (Mening. disease)11.96020.045-1.915Pertussis11.9601523.4441.484Salmonellosis1325.58052011.782-13.798Strep pneumoniae, invasive11.96040.090-1.870Total433800Prepared by Rudrani Ghosh, Regional Epidemiologist-102058-276225Preparedness00PreparednessJessamine County Health Department is prepared to respond, whether it is a localized disease outbreak, pandemic influenza, natural disaster, or man-made disaster. By working closely with first responders, law enforcement, local government, healthcare providers, and community organizations, we strive to ensure that Jessamine County is safe and ready to face any disaster. Lindsay Ames, RS, MPH Preparedness CoordinatorThe Preparedness Program has provided training for staff regarding local response plans, which include various drills, testing communication systems, and planning off-site emergency operations. The health department participates in preparedness exercises, including the Chemical Stockpile Emergency Preparedness Program (CSEPP) exercise and the Strategic National Stockpile (SNS) exercise. Because of the recent Zika outbreak, JCHD saw the need to get prepared for an outbreak in our own community. JCHD staff provided Zika education materials through various activities including setting up a table at our annual Rabies Clinics. Patient flow was set up so everyone attending the Rabies Clinics would pass the Zika information table and receive information is English or Spanish based on their needs. This event reached community members that the JCHD might not have connected with through on a normal basis. This event was recognized by the Kentucky Department for Public Health as a “Best Practice”. JCHD staff also provided Zika information at Health Fairs across the county. Staff participated in numerous trainings, exercises, conference calls, and webinars at local, regional, and state levels in order to be adequately educated and equipped to handle a Zika outbreak. JCHD monitored Jessamine County residents that traveled to Zika affected countries and provided testing when necessary. Natural disasters that occurred this year include a snowstorm in January, which Jessamine County was hit by heavy snow, about 8 - 12 inches deep. JCHD participated in conference calls and provided community updates to the Kentucky Department for Public Health during this snow storm.Jessamine County Health Department works to be prepared and ready to respond to any disaster that may come our way. For more information on Disaster Preparedness, visit our website at -100788-285750Board of Health00Board of HealthWilliam C. McCaw, DVM - ChairmanJohnny Bolton, JDThomas Coburn, MDAmanda Eschelbach, DMDChristopher Horne, PEC. Darrell Jennings, MDPatricia LaFountain, RNMike Montgomery, RPhJohn Musick, ODSuzanne Ogden, DOJustin Ray, Fiscal CourtDavid K. West, County Judge Executive390525133985Special THANKS to the Jessamine County Board of Health for their Voluntary Service and Dedication to Protecting the Health of our Citizens00Special THANKS to the Jessamine County Board of Health for their Voluntary Service and Dedication to Protecting the Health of our Citizens ................
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