Steuben County



Professional Advisory CommitteeDate:January 2, 2020Time / Location:12:00 PM – 1:00 PMMembers:Kat Potter RN; Darlene Smith, Public Health Director; Dr. Dennis O’Connor, Medical Director; Rachel Weimer, Consumer; Shivani Patel, PT; Deb Hunt, RN/ConsumerAbsent:Scribe:Terry MossAgenda ItemDiscussionAction ItemsOwnerStatus (open/ closed)Last QuarterQuarterly PMQI audit summary reports and minutes from PMQI meetings were emailed for review prior to meeting.Reviewed and discussedKat PotterClosedApproval of minutesMinutes of previous meeting emailed to members.ApprovedKat PotterClosedPolicy UpdatesAdministration PolicyThere were a lot of updating, links added and abbreviations.To the PAC policy it was added the members should be made up of representation of a vulnerable population. Attendance is a minimum of 1 meeting per year.Removed Turning Point as the designated Performance Management System used in the policy statement (as all we are required is to have a performance management system).Added under Training that there are now Core Competencies for the Public Health Improvement Professional.Infection ControlUpdating definitions, updating wording and links.Nursing Procedures and Equipment and SuppliesVital Sign Parameters Physician Reporting policy removed from manual.Added Standards for Agencies Performing CLIA-Waived Testing including Training checklists, annual competency checklists and annual attestation by the lab director.Added Biometric Screening-Alere Cholestech LDX Analyzer Protocols.LeadOverhauled due to new regulations changing guidelines. Mostly consisted of adding new parameters for the new regulations.Revised the Responsibilities of the LHD to align with new guidance.Discharge Criteria From Lead Care Coordination, updated conditions for medical discharge MCHSteuben Specific for this policy.Removed mention of MOMS program throughout document. Program no longer exists in Steuben CountyAdded Section on Documentation during Home VisitsOpioid OD PreventionNew policy due Narcan training PH administers.Correction in grammar in a few places.Added statement: The Enrollment Forms of Trained Overdose Responders will be maintained in a file at the Agency. Under the paragraph of handling the logistics for conducting training; added to have the available items available; Training Evaluation Forms.KatClosedAgency UpdateNone to reportDarleneProgram UpdatesLeadAttended a Lead conference/meeting on the new regulations and clarifications.Kat & Chan went to lead training. Chan will be back up for lead program. Learned at training that home visits are not mandatory but optimal but not required.Since October 1st have received 5 cases that would not have been managed prior to new regulations.Additional 5 more home visits that would not have been made prior to new regulations. Total 10 cases we would not have followed prior to new regulation.2019-2020 Work plan to NYS awaiting approval.Received a grant for lead through United Way to use for lead program. Will use to boost on social media, use for a lead presentation during the baby café and use for gift cards for paint for remediation.Diabetes/NDPPFirst year is complete for Bath and Hornell classes. It is a 2 year program.For the Bath class the average weight loss 5.1% which met the CDC goal. The biggest weight loss for the class was 42 lbs.Hornell class the average weight loss was 9% and the biggest loss in that class was 61 lbs.Currently recruiting now for class to start in February.Public Health Emergency PreparednessMet with Village Square Apartment residents (9 totals) to share emergency preparedness information, jointly with Steuben OES. Working on update of Public Health Emergency Preparedness and Response Plan, In process of finalizing the After Action report of the October CSS Exercise.Breastfeeding CoalitionBaby Café closed at the Dorman Library in Bath. Not enough attendees. Working on opening a Baby Café in Corning at the new office building next to the hospital.The hospital stressed an interest due to the OB/GYN providers are in the building. Feel that it may increase numbers if mom’s has an appointment they may stop in to Baby Café.MCH Universal Home Visiting-QI Project this year to increase home visit acceptance. We increased visit some but visits acceptance is still down. Goal was to increase some which has been achieved. Project was open for 1 year. Will close this project at this time. Will be meeting with Kids on Track which their goal is to make home visits increased.Received Turtle Beach money and did a Facebook boost about the program. Had a giveaway of a stroller. Purchased some incentives to give to moms during home visit.Will give away another stroller at the next community baby shower which is being held in Hornell.Rabies-For the year there were 13 positive animals. 4 raccoons, 3 fox, 2 bats, 3 skunks and 1 cat.Rabies Post Exposure numbers were better this year. Last year 84 and this year 52.Corning Hospital created a universal reporting rabies sheet that can go out to all hospitals and providers. This will be the same for all counties.EI Early Intervention is replacing their internet based system (NYEIS) with a target of July 2020.Proposed change to service coordination billing is on hold.STD All STD’s on the rise in NY.Numbers pulled for 3 year period for Steuben County. Gonorrhea 2017-24 cases, 2018-46 cases, 2019- 63 cases at beginning of December and more cases have been reported.State concern seeing the same increase through the whole state. Concerns on syphilis # increase and women of child bearing age causing birth issues.We are part of the EPT program was we are trying to get providers to offer partner treatment of chlamydia. NYSDOH offering incentive for promoting and if providers encourage EPT the state will give some monies back for doing it. The offering is part of the investigation and needs to be documented.AccreditationAll our documents have been submitted to the other counties for review.Expect to have submitted to the accreditation board in February. The deadline is mid-March but hoping to get in sooner.FluWidespread. There has been 1 pediatric death in Monroe County.So far this year Steuben has had 118 confirmed the number almost double from the beginning of flu season until 12/27 there were 60 cases. From 12/27 until the New Year there were 44 more cases.Influenza B has been predominant in Steuben. This is not covered in the flu vaccine.The influenza A strains that are going around in Steuben and they are in the flu vaccine this year.HepatitisHave a new dry spot confirmatory test for Hepatitis B. This replaces a venous sample.RadonLorelei did a press release in November for lung cancer awareness month on the radon’s impact on lung cancer. There were 100 kits distributed from the press release. She was asked to speak on WVIN radio on radon.Biometric ScreeningCompleted 2019 employee testing of 577 employees. 289 of those employees tested received flu shot. This was comparable to previous year.TBContinue to do direct observational for 2 active TB cases 2-3 times a week. Will be completed in March. The latent TB test that was linked to the 2 active TB clients has completed treatment last month.CHIP/CHAFinalized and sent to state in mid-December.Kat PotterClosedClosedAudit ReportsTB LHCSA Chart ReviewNo discharge summary for LTBI case.MCH ReviewOver sight of last box checked on forms-Missed checking no further visits onMCH LHCSA – no patientsCD1 lab reported within 48 hours, not 24 hours. There was 1 case of salmonellosis with incomplete documentation. Had unknown for occupation. Billing Audit94 claims, 1 claim not billed, date of service on note and daily activity sheet should match, 4 instances where note date of service needed to be changedLead LHCSA- No PatientsImmunizations ChartWhen screening, nurses didn’t carefully review the screening questions to make sure all questions were answered and did not address any yes/don’t know responses. The nurses could have offered 1 vaccine to 2 different clients. VFC/VFA eligibility screening was not documented on one questionnaire and 2 questionnaires were missing the VIS publication dates.EI IPRO Audit- 100%Latent TBThe dates were missing when patients were diagnosed with diabetes.STD/HIV clinic1 Chlamydia case and 1 Gonorrhea case did not receive appropriate treatment. Both were lost to follow up after 1 month of provider and NYSDOH trying to contact patient. The Chlamydia case did not receive any medication and the Gonorrhea case received only the Rocephin injection, no azithromycin. KatClosedSatisfaction Survey’sSTD Jail44 survey’s given out at time of clinic with returned of 40 surveys completed (91%). NDPPAll pretty much positive. Some general complaints on the meeting times and tracking task.KatClosedAccidents & IncidentsGroup met in regards to a potential HIPPA Breach. Assessed and discussed the situation. SCS emails back and forth to school districts list of children that needed services and the email was not confidential. It was decided it was not a HIPPA Breach. Beefed up education to staff and sent out reminders to external partners to make sure everything is encrypted.KatClosedOther BusinessODMAP-Software for Overdose Detection Mapping Program. Steuben has been working on implementation and today was the 1st day live. 911 will document overdose calls and 1st responders will report whether non-fatal or fatal and how many Narcan doses was used. 911 will enter address of the place overdose occurred. A sheriff & peer specialist will make a visit within 24 hrs. to help assist with resources for help. This data will all be real time data and is accessible for other agencies to see the data.Provider Page- Sent a copy out to committee for review. DarleneClosedPerformance Measures3rd quarter 2019Performance Measures sent out prior to committee meeting for their review. Reviewed quarterly performance measures as a group and highlighted on items that need improvements.Admin- % of completed Action Plan items for PHAB were not completed during the 3rd quarter but are now complete.PMQIAll targets met.Chronic DiseaseIn good progress.Hypertension measures were removed. They were not a priority this year.CD1 issue in the Hepatitis B reporting. Main staff off for a period of time and 2 employees covering not familiar with the program so the time frame on a couple things were not in the 72 hrs. Emergency PreparednessCore trainings were met but any additional trainings staff can have not been met.Volunteer pool continues to be below target.MCH# of Antepartum Referrals% of Antepartum referrals who accept visit# of Post-Partum Referrals% of Post-Partum referrals who accept visitThe numbers have all increased from what they were but continue to be below target but are close to targets. We have also noted that the birth rates are also down.ImmunizationThe national observances were down in the 3rd quarter but have been met in the 4th quarter.% SCPH HIV/STD clients that are eligible and completed the Hepatitis A series- Less than target but greater than baseline. This is due to changes at jail with new company taking over after NP and MD left.Rabies% of people who started PEP was down but improved last quarter.% of bats tested/total human bat exposures- had 4 refusals last quarter.# of pets vaccinated- this has slowly decreased probably due to the use of Tractor Supply.Lead# Presentations held at town/village/city boards with lead prevention education- This has not been met due to a town canceling presentation. State aware and was ok with it.The percentage of children with BLL >5 via a FS, confirmed w/venipuncture within 30 days. Rates gone down have a new tracking system which are more accurate and have seen the number rise.EI% EI IFSP completed by 45 days% EI Services started by 30 days after IFSPNot meeting deadline. This is due to capacity issue with evaluation team.HIV/STDThe percentage of gonorrhea cases with adequate treatment.Clients were not treated appropriately which brought the numbers down.# of inmates at jail provided with HIV/STD testing/education.This was due to the change in medical staff at the jail.TBThis is a new program that was added to the dashboard therefore not a lot of targets or baselines. There was no one that did not complete treatment.Injury PreventionClose to targets the only thing that was off was car seats but still have the next quarter to complete.KatClosedStrategic Plan3rd quarter 2019Sent out for review prior to meeting. Members reviewed and had no questions.Will be starting a new 3 year plan.DarleneClosedNEXT MEETING:Next Meeting Date: Wednesday, April 8, 2019 12:00 PM Steuben County Office Building G2 downstairs to the right of PH.Emailed to members XX/XX/20 ................
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