Okaloosa County BOCC — 2013 meeting #1143 (date undetermined) — 2-2 County Health Department — reading text

prenatal care to enhance optimal pregnancy outcomes Assessment and treatment for children without access to other sources of medical care Insulin for diabetic patients who qualify Screening for breast and cervical cancer to women under the age of 65 Comprehensive primary care services to persons age birth to 64 years who qualify for enrollment in the Opportunity Health Clinic program Urgent care services for children and adults in the One Problem Clinic e Primary care, medical case management, access to life-saving medications, and community collaboration in the prevention and medical care for persons living with HIV/AIDS Dental Services: Dental Services consists of licensed dental professionals (dentists and dental assistants) and administrative/clerical personnel who provide direct dental services to children. The Florida Department of Health in Okaloosa County operates a 4-chair dental operatory in the Crestview clinic e Oral health (dental) services for children age 4 through 18 years WIC Program: The Women, Infants, and Children (WIC) program is a federally funded nutrition program. WIC provides at no cost to income eligible families: healthy foods, nutrition education and counseling, breastfeeding support, and referrals for health care. The WIC target population is low-income, nutritionally at risk: Pregnant women (through pregnancy and up to 6 weeks after birth or after pregnancy ends). Breastfeeding women (up to infant's 1* birthday) Nonbreastfeeding postpartum women (up to 6 months after the birth of an infant or after pregnancy ends) Infants (up to 1* birthday). WIC serves 53 percent of all infants born in the United States. Children up to their 5" birthday. WIC is not an entitlement program as Congress does not set aside funds to allow every eligible individual to participate in the program. WIC is a federal grant program. No state or local funds support this service, Healthy Start: The Healthy Start program assists pregnant women, women between pregnancies, infants, and children up to age 3 to obtain the health care and social support needed to reduce the risks for poor maternal and child health outcomes including infant mortality, and to promote good health and developmental outcomes. Every pregnant woman and every child born in Florida is eligible for Healthy Start Prenatal or Infant Risk Screening and the program goal is universal screening. The Florida Department of Health in Okaloosa County provides this service as a subcontractor of the Okaloosa-Walton Healthy Start Coalition. School Health: School health services are provided in Okaloosa County through the combined efforts of the school district and the health department. Each county school health program develops a biennial school health services plan that identifies local implementation strategies and responsible parties for the provision of health services in public schools. In Okaloosa County the following school health services are offered for students in Pre-K through 12" grade: Record review and follow-up to assure that all incoming students have a school entry health exam, immunization for grade-level, and that any chronic health problems are being addressed; Vision, hearing, growth and development, and scoliosis screening in grade levels mandated by Chapter 64F-6.003, Florida Administrative Code that provide early identification and remediation of problems which may impact a student's ability to learn; Nursing assessment, health care planning and delegation for the provision of school-based health services needed by students in order to attend school; Planning and provision of emergency health services for students who are injured or become acutely ill at school; Participation in curriculum development for health education; Consultation with parents and school personnel on health issues that interfere with a student's ability to fully participate in school activities; Record review, screening, and participation in meetings for the placement of students in exceptional education programs. REVENUE: The Florida Department of Health in Okaloosa County is funded with state general revenue, tobacco trust fund revenue; federal funds allocated through the state and through direct federal grants; client fee collections; medical insurance collections (including Medicaid, Medicare, and third party health insurance); other grants from state and local sources; and county general revenue. Category State FY11 State FY 12 State FY13 BCC Direct Support to CHD $0 $607,602 $623,699 EXPENDITURES: Category State FY11 State FY 12 State FY13 Personnel Services $6,945,629 $6,494,552 $6,441,602 Operating Expenses $1,497,895 $1,512,920 $1,331,078 Capital Outlay $268,425 $286,218 $104,920 TOTAL $8,711,949 $8,293,690 $7,877,600 HISTORICAL STAFFING SUMMARY: Category State FY11 State FY12 State FY13 Funded FTEs 121.20 123.20 111.86 FTEs are counted for positions established within state government which includes Career Service, Select Exempt Service, or Senior Management Service. Other Personal Services (OPS) are hourly paid workers and are only paid for time worked with minimal benefits. These positions are not counted in the funded FTEs. In FY13, the OCHD had 25 OPS workers to support the delivery of public health services. Hours worked ranged from ~4 — 40 hours per week. MAJOR ACCOMPLISHMENTS FOR FY2013 Community Health Improvement Planning: In March 2012, community partners identified four community health issues as priority areas: Improving access to health care at lower expense Healthier, active children, youth and adults through improved nutrition and increased physical activity Tobacco free living Clean water (healthy beaches and properly functioning septic and sewage systems) During FY 13, three workgroups convened and focused on the top three priority areas: « Improving access to care e Improving physical activity and nutrition e Reducing tobacco use The workgroups have developed action plans to implement strategies in these priority areas. The Tobacco workgroup is addressing prevention and cessation activities, with a special focus on youth in our county. The Nutrition and Physical Activity workgroup is focusing on promoting healthy lifestyles through the development and promotion of a county-wide electronic database of ail physical activity opportunities and nutritional resources. The Access to Care workgroup has developed strategies for improved coordination of existing resources (NWFL 211 system) and to address the need for more primary care providers who serve the medically underserved in our county. All workgroup action plans include strategies focused on lasting environmental and policy changes using recognized evidence-based practices. Emergency Preparedness and Response: In FY13, the Emergency Preparedness and Response (EP&R) Branch worked with Okaloosa County Emergency Management and the American Red Cross to create the Okaloosa County Functional Needs Support Services (FNSS) component of the Okaloosa County Comprehensive Emergency Management Plan. The FNSS component delineates agency responsibilities between Emergency Management, American Red Cross and the Florida Department of Health in Okaloosa County (DOH-Okaloosa) to allow citizens with functional needs to maintain their independence in emergency evacuation shelters. The Branch reviewed and updated each of the 37 individual emergency response plans within the DOH-Okaloosa All-Hazards Emergency Response Plan, ensuring health department capability to respond with community partners to emergencies and disasters within the county. The Branch reviewed 118 home health agency, hospice, home medical equipment provider and nurse registry Comprehensive Emergency Management Plans (CEMPs) against Florida Statutes and Florida Administrative Code and when necessary worked with the agencies to correct deficiencies in the plans. Thorough review and correction of deficiencies in these CEMPs increases the probability that the agencies will be able to continue priority services to their clients in Okaloosa County. The EP&R Branch continued its strategic oversight, management of, and recruitment for the 306-member Okaloosa-Walton Medical Reserve Corps (OWMRC). The OWMRC mission is to supplement the local public and health and medical system during emergencies and disasters. The corps is critical to an emergency response requiring operation of mass medication dispensing and vaccination sites and alternative care sites. Though the OWMRC was not activated for emergencies in the past fiscal year, volunteers donated service hours valued at $3,291 for community outreach, client services and preparedness training. The EP&R Branch also taught 21 Basic Life Support for Healthcare Providers courses to health department staff and OWMRC volunteers to ensure a workforce ready for quick and effective response to cardiac and respiratory emergencies. Disease Surveillance: In FY13 (7/1/2012 — 5/17/2013), 640 reportable diseases were investigated and reported to the Florida Department of Health (DOH). This represents an 18.5% increase in reportable cases. Surveillance staff reported and provided guidance including control measures for an influenza outbreak at a skilled nursing facility and two gastrointestinal illness outbreaks at assisted living facilities. Surveillance staff also worked with our Environmental Health (EH) staff and local mosquito control to provide information on targeted spraying after 4 cases of West Nile virus infection was reported. In addition, surveillance staff worked with the State Epidemiology Bureau to locate, assesses, and refer as needed contacts to the multistate fungal meningitis outbreak. A challenge this year was a multi-site outbreak of Shigellosis at local childcare facilities. By working aggressively with our internal EH staff and regional DOH epidemiologists, this county-wide outbreak was contained within a two-month period. Neighboring counties have had Shigella outbreaks in their child care and communities that have continued for many months. Despite a very busy workload, the surveillance staff was able to maintain 100% of their Performance Measures as assessed by the State Epidemiology Bureau. Tuberculosis Control: Four active tuberculosis cases were treated this past year. In addition, there were up to numerous contacted to a complex multi-drug resistant case that resulted in latent tuberculosis treatment follow up for 8 contacts. With the closure of AG Holley Hospital, our local health department has served as a test county for managing a very complex TB client outside of a hospital setting. This required some innovative ideas for housing that resulted in the purchase of a travel trailer to house infectious or homeless clients. Providing them with a stable living arrangement has greatly increased the probability of compliance with this client's treatment course while keeping the community safe from exposure. Tobacco Prevention and Cessation: In conjunction with our local Community Health Improvement Planning group, the tobacco program developed goals to decrease the number of Okaloosa residents that currently use or may initiate the use of tobacco. The Students Working against Tobacco (SWAT) youth presented tobacco information before the city councils of Fort Walton Beach, Crestview, and Laurel Hill. They were successful in getting resolutions unanimously passed in those cities urging retailers to ban the sale of candy flavored tobacco not covered by the FDA regulations. Environmental Health: Environmental Health continues to utilize the electronic records for facility inspections within the environmental health programs. Significant savings have been realized with staff time, reduction in paper cost, and customer satisfaction with the new paperless initiative. Inspectors conduct inspections utilizing a laptop in the field and then are able to provide an email copy of all facility