2015 Annual Report - Garrett County Health Department

Presented to the Board of Garrett County Commissioners on September 12, 2016
By: Rodney B. Glotfelty, R.S., M.P.H.

CDC TEN ESSENTIAL SERVICES
1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health hazards in the
community.
3. Inform, educate, and empower people about health issues.
4. Mobilize community partnerships and action to identify and solve health
problems.
5. Develop policies and plans that support individual and community health
efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision
of health care when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9. Evaluate effectiveness, accessibility, and quality of personal and
population-based health services.
10. Research for new insights and innovative solutions to health problems.
*10 Essential Services & Graphic from CDC
Visit us online at GarrettHealth.org!

GENERAL INFORMATION
“A Local Health Department is a hybrid entity
that is a unit, agency, or instrumentality of the
State for some purposes and of the County for
others.”
– David Morgan, DHMH Asst. A.G.
• Health Officer appointed by the Secretary of Health upon
recommendation of County Commissioners
• Garrett County Board of Health consists of the Garrett County Board of
Commissioners with the Health Officer as Secretary

GOVERNANCE
• Health Officer administers delegated programs from Secretaries of
Health
• Examples are communicable disease surveillance and control,
maternal and child health program, Medicaid enrollment, and
environmental health regulatory programs
• Health Department administers ordinances adopted by G.C. Board of
Health (Deep Creek Sewage Ordinance and Sewage Sludge Disposal
Ordinance)
• The Health Department Core Service Agency was designated as the Local
Management Board by the County to administer child and family services
in 2011
• The Health Officer also serves as the chair of the LMB
• The Health Department was also designated as the local CSA in 2004, and
the Local Addiction Authority in 2016

GOVERNANCE – BOARD OF HEALTH
• Board of Health consists of County Commissioners and Health
Officer as Executive Officer
• Ability to enact local ordinances related to conditions that may be
injurious to health without specific legislative approval
• Meets jointly with the Health Planning Council at least twice per
year.
• Is represented on the Health Planning Council by at least one
Commissioner and the Health Officer as permanent Secretary
• Is updated at least once per year on the “Status of Health” in the
community

POLICY DEVELOPMENT
• Health Planning Council
• Semi-Annual Board of Health
Meeting
• “Status of Health” Report
• Local and State Boards,
Associations, and Committees
• Website – GarrettHealth.org
• Program updates to
Commissioners

HEALTH PLANNING COUNCIL
• “Community Needs Assessment” (CHA)
• Establishes strategic priorities
• “Health Improvement Plan” (SHIP/CHIP)

POLICY DEVELOPMENT
• PHAB uses standards and
measures as a framework for
evaluating a health
department’s processes,
services, outcomes, and
progress toward specific
goals and objectives
• We are currently in the
Action Plan phase, and will
be submitting our final plan
on October 1, 2016
• Allegany, Frederick,
Hartford, and Worchester
counties are among the 151
HD in the U.S. that have
received accreditation
• We hope to be next!

GCHD – GENERAL INFORMATION
• Workforce: 98 merit, additional special pay and 3rd party
contractual employees comprise a total workforce of
approximately 150 individuals
• Budget: approximately $13,000,000
• Funding: state core dollars, local core dollars, state targeted
grants, direct federal grants, pass through federal funding,
and fee for service programs
• Less than 12% of total funding comes from local government

ENVIRONMENTAL HEALTH SERVICES 2015
• Individual well and septic
• Rabies and other zoonotic disease control
• Food service permits
• Environmental lead evaluations
• Recreational sanitation
• Communicable disease investigations
• Transient vacation rental unit inspections

Well
• Issued 99 well construction
permits
• 1,355 total water samples
collected, 844 visits were made
• 67 “Certificates of Potability”
(COP’s) were issued
Water Systems
• 525 bacteria and 438
chemical individual water
samples were collected
• 346 bacterial and 15 chemical
samples collected from
mobile home parks
• 318 bacterial and 74 chemical
samples collected from non-
transient community water
systems

WATER SAMPLES COLLECTED 2006-2015
2506
2389 2384
1957
1726
1544
1315
1526
1287
1355
1877
1670 1728
1294
1115
926
842
926
808 844
0
500
1000
1500
2000
2500
3000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
# OF SAMPLES COLLECTED # OF STOPS

Septic
• Sewage program:
• 67 soil evaluation tests
were completed
• 116 septic permits were
issued
• 19 best-available
technology nitrogen
reduction systems were
installed
Food Service
• 299 permanently licensed
food
service facilities
• 506 inspections conducted
• 125 temporary permits
issued

SEPTIC DATA 2006-2015
200
158 134
98 97 93 96
66 77
116
456
328
131
148
88
56
137
65 56
67
0
100
200
300
400
500
600
700
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
# OF SEPTIC PERMITS ISSUED # OF SOIL EVALUATION TESTS COMPLETED

FOOD INSPECTION DATA 2006-2015
0
100
200
300
400
500
600
700
800
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
# of Permanent Food Service Facilities # of Inspections Required by Law
# of Inspections Conducted # of Temporary Permits Issued

Recreational Sanitation
• Seasonal water quality
testing conducted at 10
bathing beaches and 1 lake
• 45 swimming pool
inspections and 21
campground inspections
were made
Rabies Control
• 1,145 animals were
vaccinated
• 35 animal bites were
reported
• 44 animals tested, 15 were
confirmed positive

RABIES DATA 2010-2015
57
67 66
59
62
35
45 45
22 23
39
31
21
18
44
15
8
6
4
6
2
6
2 1
15
0
10
20
30
40
50
60
70
80
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
# of Animal Bites Reported # of Animal Tested # of Confirmed Cases

ANIMALS VACCINATED 2006-2015
0
200
400
600
800
1000
1200
1400
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Total # of Animals Vaccinated

Transient Vacation Rental Units
• 728 licensed transient vacation
rental units
• 359 transient vacation rental unit
inspections completed
Air Quality
• 889 burning permits issued
*Images from DeepCreekLodging.com

INSPECTIONS BY PROGRAM 2015
Non-Community
Transient Water
Systems
<1%
Mobile Home Park
1%
Rabies
2%
Nuisance Complaints
3%
Recreational
Sanitation
4%
Septic
13%
Transient Vacation
Rental Unit
16%
Food Facility
23%
Water
38%
Non-Community Transient Water Systems
Mobile Home Park
Rabies
Nuisance Complaints
Recreational Sanitation
Septic
Transient Vacation Rental Unit
Food Facility
Water

PERSONAL HEALTH 2015
• 779 adult immunizations
• 329 child immunizations
• 837 seasonal influenza
vaccinations were provided to
adults and children
• 216 tuberculin skin tests
completed on 195 people
• 185 HIV tests complete
• 11 HIV positive individuals and
families received advocacy
services

IMMUNIZATIONS FOR CY 2015
1666
779
707
329
0
200
400
600
800
1000
1200
1400
1600
1800
ADULT CHILD
Vaccines Administered Patients

PERSONAL HEALTH 2015
CPEST Program
• “Cancer Prevention, Education,
Screening, and Treatment”
• 51 unduplicated clients
screened
• Colonoscopies: 27 screened, 18
polyps removed, 0 cancers
detected
• Skin biopsies: 31 screened, 5
precancerous lesions removed,
1 cancer detected
BCCP Program
• “Breast & Cervical Cancer
Program”
• 92 unduplicated clients
screened
• 215 procedures completed
• 92 screening mammograms &
3 biopsies
• 2 breast cancers detected
• 1 cervical cancer detected

CPEST DATA FOR CY 2015
51
27
6
31
15
1
5
0
10
20
30
40
50
60
Unduplicated Number of Clients Colonoscopies Completed
Precancerous Colon Conditions Detected Skin Exams Completed
Skin Biospies Completed Basal Cell Cancer Detected
Precancerous Skin Lesions Detected

BCCP DATA FOR CY 2015
10
1
112
2
140
4
304
13
158
11
97
0
0
50
100
150
200
250
300
350
FEMALE MALE
<15 15-17 18-19 20-24 25-29 30-34

FAMILY PLANNING 2015
• 575 unduplicated clients served
• 1,002 encounters completed
• 6 colposcopies completed
• Provided 302 oral
contraceptives, 194 hormone
injections, and 16 other critical
family planning services

FAMILY PLANNING DATA FOR CY 2015
10
1
11
112
2
114
140
4
144
304
13
317
158
11
169
97
0
97
56
2
58
44
3
4741
4
45
0
50
100
150
200
250
300
350
FEMALE MALE TOTAL
<15 15-17 18-19 20-24 25-29 30-34 35-39 40-44 45+

SCHOOL BASED IMMUNIZATION CLINICS 2015
• 489 intranasal influenza
vaccinations were
provided to elementary
school children
throughout the county

BIOTERRORISM/EMERGENCY PREP 2015
• Collaborates with partner agencies to
respond to and provide public health
services in disasters
• Available 24/7 through GC Public Safety and
Emergency Management Office
• HD staff participate in 4 quarterly county
meetings, Monday conference calls, 6
Healthcare Council Meetings, 1 regional
meeting, and 1 annual meeting per year
• Completes 1 facility set-up drill, 1 through
put drill, 1 operational readiness review, 4
satellite phone drills, and 4 employee
notification drills

HEALTH EDUCATION & OUTREACH 2015
Provide services to promote and encourage healthy
behaviors to prevent:
• Alcohol and drug abuse
• Tobacco use
• Obesity
• Injuries
• Teen pregnancy

COMMUNITY HEALTH CAMPAIGNS 2015

SERVICES FOR THE COMMUNITY 2015
• After school programs:
• Provided for 112 youth
• Car seat loaner program:
• Loaned 113 seats
• Parenting programs
• Provided to 15 families
• Tobacco cessation program
• Served 51 tobacco users
• Dietitian consults:
• Educated 45 clients
• Bike helmet distribution
• 141 helmets

COMMUNITY INVESTMENT 2015
• Mini-grants to community groups
to provide community-based
activities:
• $16,600 to 4 groups
• Mini-grants to clubs that support
peer education:
• $2,400 to clubs
• Partnership with pharmacies to
provide tobacco cessation aids:
• $8,000

LAW ENFORCEMENT PARTNERSHIPS 2015
• Partnership with law
enforcement agencies to
conduct compliance checks for
tobacco and alcohol
• Implemented safe prescription
drug drop-off boxes with partner
agencies
• Total law enforcement
partnerships program
contributions:
• $11,100

EARLY CARE SYSTEM OF CARE 2015
• Strategy: Provides and/or links
families and children with an
array of health, education and
support services to form the
Garrett County Early Care
System of Care
• Programs:
• Healthy Families
• Early Head Start
• MCHP

EARLY CARE SYSTEM OF CARE 2015
• Targeted outcomes:
• School readiness
• Improved birth outcomes
• High immunization rates
• Improved life course
• Cost–benefit of program
• $5-$7 return on investment

PREPARING FOR A MEDICAL HOME 2015
• Childbirth classes are offered 12
times/year
• Breastfeeding classes are offered 11
times/year
• Socializations are offered every month
from birth to 5 years
• These programs are a gateway to
healthy behaviors and additional
services, such as immunizations

WIC 2015
• 804-908 clients per month – 70-80% of all Garrett County
Births served by program
• State of the art data system to track health indicators
• Nutritional education
• Breast feeding education and support
• Coordination with other programs
• Supplemental foods (approx. $650,000 to local economy
yearly in food expenditures)

WIC PARTICIPANTS FOR CY 2015
492
366 370
508 494 491
373 349
381
1263
1209
1242
0
200
400
600
800
1000
1200
1400
2013 2014 2015
Infants Children Women Total

WIC PARTICIPATION & ENROLLMENT CY 2015
777
786
800 800
786
817 820
841 840
847
859 859
813
804
814
835
819
842 848
867 870
882
894
908
700
750
800
850
900
950
Participation Enrollment

BREASTFEEDING BY PARTICIPATION 2015
0
5
10
15
20
25
30
35
40
14-JAN 14-JUL 15-JAN 15-JUL 16-JAN
% Infants Breastfeeding % Exclusively Breastfeeding
% Oakland Breastfeeding % Oakland Exclusively Breastfeeding
% Grantsville Breastfeeding % Grantsville Exclusively Breastfeeding

DENTAL HEALTH 2015
• Health Department Dental Clinic established February
2001 to see children with MA
• With the MD Healthy Smiles program, the GCHD clinic
now targets children with MA coverage and uninsured
and underinsured adults
• 1,399 children for clinical visits in 2015
• 1,322 adults for clinical visits in 2015
• SHIP Data ranks GC #1 in the state for MA Children
Receiving Dental Care (2013)

DENTAL HEALTH 2015
• School fluoride rinse program
available for every elementary
school (953 children participated
in the 2015-2016 school year)
• Dental evaluation at
kindergarten registration and
Head Start

DENTAL HEALTH 2015
• Ongoing collaboration
with the Mountain
Health Alliance (AHEC):
• 93 high‐risk adult
un-insured patients
in severe need of
treatment were seen in
CY 2015
• Total value of services
provided to high risk,
uninsured adults
exceeded $290,000
• 402 adults received
Emergency Treatment
• Emergency Department
Visit Rate For Dental Care
is a focus area for SHIP in
2017 and an area we rank
11th in Maryland

Behavioral Health 2015
• Intake and diagnosis
• Individual and group therapy
• Intensive outpatient treatment (substance abuse)
• Anger management
• Trauma services
• Parenting skills
• Medication management
• Co-occurring treatment
• Geriatric services and home visiting

BEHAVIORAL HEALTH CLIENTS 2015
1144 1200 1183 1259
88
92 76
68
536 492
442
489
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2012 2013 2014 2015
Mental Health MH CM SRD
MH CM = Mental Health Case Management | SRD = Substance Related Disorders

BEHAVIORAL HEALTH SERVICES 2015
14162 15520
23058
30966952
681
588
432
6089
6850
5658
12308
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2012 2013 2014 2015
Mental Health MH CM SRD

BH SERVICE AREA BY PERCENTAGE 2015
69% 69% 70% 71%
26% 26% 25% 25%
5% 5% 5% 4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013 2014 2015
Adult Child Jail

BEHAVIORAL HEALTH 2015
• Information and referral
• Drug testing
• “Acu-Detox”
• MVA sanctioned DWI treatment
• Jail-based treatment
• Pre-court evaluations
• Peer recovery support
• Crisis services
• Overdose response training
(127 in 2015)
• 60 doses of Naloxone dispensed in 2015

SUBSTANCE ABUSE SERVICES 2015
• Patients: 486
• Adult: 459
• Child: 27
• Services: 11,946
• Group visits: 2,573
• Consults: 249
• Education patients: 32
• Pre-court assessments: 48
• Individual visits: 290 (30 minutes), 573 (60 minutes)
• DSS customers screened for substance use disorders: 925

MENTAL HEALTH SERVICES 2015
• Patients: 1,251
• Adult: 866
• Child: 427
• Total # of services: 30,384
• Psychiatrist visits: 2,019
• Intake diagnostics: 760 (scheduled), 422 (kept)
• Med evaluation: 35
• MH case management: 63 patients, 386 services

ADULT SERVICES 2015
• Provides assistance to functionally and chronically disabled adults who are at risk
of institutionalization
• 1,446 individuals served
• STEPS assessment: evaluation process used to determine the level of care a
client may need
• STEPS facility: STEPS that determines the level of care for a nursing facility
placement
• PASSAR assessment: evaluation used to determine the level of care for someone
who is mentally ill or mentally incapacitated secondary to a medical condition
• CFC assessment: RN completes a detailed history to determine if the client is
safe to remain in the community
• Nurse monitoring (NSG): RN periodically evaluates the care provided in the home
provided by an agency to ensure quality

AERS DATA FOR CY 2015
0
20
40
60
80
100
120
140
160
180
Nsg Monitoring PASSAR CFC STEPS Facility STEPS

HOME HEALTH 2015
• Only Medicare-Certified Home Health Agency exclusively in
Garrett County
• Only agency still with local Health Department in Maryland
• Important for continuum of care in community
• Reimbursed by Medicare, Medical Assistance, insurance, and
self-pay
• 9,545 Total Visits

TELEMEDICINE & HOME HEALTH 2015
• “Health Buddy” home units
provide for remote monitoring
from home to central station
Telehealth RN
• Continued to support 46
clients through September of
2015 for improved outcomes
and reduced signs of
symptoms

TELEMEDICINE & HOME HEALTH 2015
Benefits
• Improves outcomes while
controlling costs
• Increases self management,
and disease knowledge
• Assists in promoting pro-
active, healthy life styles
Partner Issue
• The Health Department is
currently searching for an
alternative vendor after the
closing of the previous
vendor’s operations

MEDBANK 2015
• Provides medication for uninsured/underinsured individuals
who lack resources to obtain prescriptions by working with
the pharmaceutical company’s charity care program
• This program was recently rebooted by the Garrett County
Health Department, following the dismantling of this service
on the state level
• Data will be available for this program beginning in CY 2016

ADMINISTRATION 2015
• Issuance of 946 birth and
2,290 death certificates for
369 residents
• Personnel management
• Fiscal management
• Procurement
• “Community Health
Assessment” and “Community
Health Improvement Plan”
• Supervisory oversight

QUESTIONS?
rodney.glotfelty@maryland.gov
*Photos from CDC, Unsplash, Pexels, Pixabay

2015 Annual Report - Garrett County Health Department

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to 2015 Annual Report - Garrett County Health Department

Similar to 2015 Annual Report - Garrett County Health Department (20)

Recently uploaded

Recently uploaded (20)

2015 Annual Report - Garrett County Health Department