Protecting Rhyse and others through vaccination

12016 Annual Repor t
Ot tawa Count y Depar tment of Public Health
2016 Annual Report
NOW SER VING
restaurant
inspection
reports
online
Rhyse
can't get
vaccinated
He depends on others to
PROTECT him from vaccine
preventable diseases
Across count y lines:
Ottawa & Allegan
County partner
to address health needs
It's real because it's local.
Youth survey enables schools and
parents to make informed decisions

The activities and programs of this department are brought to you by the members of the Ot tawa County Board of Commissioners:
Chairman Greg DeJong | Vice-Chairman Roger Bergman | Frank Garcia | Joe Baumann | Don Disselkoen | Al Dannenberg
Mike Haverdink | Kelly Kuiper | Jim Holtvluwer | Philip Kuyers | Mat t Fenske
2 www.miOttawa.org/miHealth
In this issue
Page Rhyse can't get vaccinated. He depends on others to
help protect him from vaccine preventable diseases.
Annah has much to say, if you make time to listen.
Speech therapy helps teenager with Down syndrome.
Now serving restaurant inspection reports online.
"I'm learning to be at school." Hearing and vision
screenings help children succeed in school.
Some people may not understand the struggles
that come with not having health insurance.
Are Ottawa County beaches clean?
Zika virus: Travel related cases, no pregnant women.
Miles of Smiles mobile unit expands services to adults.
Childhood lead exposure.
M231 Run & Relay fundraising event.
Hazardous waste contaminates drinking water.
Vision: Available supply of well-balanced meals for all.
Across county lines: Ottawa and Allegan County
partner to address health needs.
Sex education and STD testing in schools.
"It's real because it's local." Youth survey enables
schools and parents to make informed decisions.
Substance abuse prevention program addresses
underage access to alcohol and tobacco.
Dispensing site exercise: Public health preparedness
and response to a biological outbreak.
Financial Statement
Sources
Click the play but tons in the online repor t to hear more
about our stories. www.miOttawa.org/health2016
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Assistant Health Of f icer
Donovan Thomas, MBA
Medical Director
Paul Heidel, MD, MPH
Epidemiologist
Marcia Mansaray, M.Sc
www.miOttawa.org/HealthData
Communications
Kristina Wieghmink, M.Ed
Emergency Preparedness
Jennifer Sorek, MA, MEP
www.miOttawa.org/Prepare
Innovation & Technology
Tony Benjamin, MSA
Clinic Services
Helen Ash, BA
Communicable Disease Control
www.miOttawa.org/DiseaseInfo
Disease Reporting
www.miOttawa.org/DiseaseReporting
Immunizations & Travel Clinic
www.miOttawa.org/Immunize
Sexual Health & Birth Control
STD Testing & Treatment
www.miOttawa.org/SexualHealth
Community Health Services
Sandy Boven, M.Ed
Children's Special Health Care Services
www.miOttawa.org/CSHCS
Health Insurance Enrollment
www.miOttawa.org/HealthInsurance
Health Promotions
Nutrition & Wellness
www.miOttawa.org/Nutrition
Sexual Health Education
www.miOttawa.org/SexEd
Substance Abuse Prevention
www.miOttawa.org/SAP
Hearing & Vision Screenings
www.miOttawa.org/HearingVision
Maternal & Infant Health Program
www.miOttawa.org/MIHP
Oral Health
www.miOttawa.org/Dental
Environmental Health
Adeline Hambley, MBA, REHS
ecoOttawa
www.miOttawa.org/eco
Food Safety Program
www.miOttawa.org/Food
On-site Services
www.miOttawa.org/EH
I am pleased to present the 2016 Ottawa County
Department of Public Health (OCDPH) Annual
Report.This year I celebrated my 10th
year as
Administrative Health Officer, and I continue to
be awed by the exceptional work and continuous
improvements made by our public health staff. With
the speed at which the world is changing and the
new public health threats that continue to emerge,
we must continue to be strategic yet flexible, scientific yet creative and
leaders as well as community partners.
Recently, while cleaning out a storage room in our building, one of
our team members found a handmade booklet containing newspaper
clippings.The articles were about the work of our department during the
1930s and 1940s. Some of the health threats mentioned from that period
included polio, measles, tuberculosis and diphtheria.There were articles
about rabies cases and unsanitary living conditions; children without
dental care and disease outbreaks caused by unpasteurized milk. One
article reported on the need to educate youth about syphilis, which was
described in 1938 as a “present day scourge” of more than six million
cases in the U.S.Another article spoke about an award our department
received, “County has ranked high nationally for work in public health.”
For me, this was more than just a pleasant walk down memory lane.
It was a reminder of the many public health accomplishments that have
led to healthier people and improved quality of life. Examples include:
the near elimination of diseases like polio, measles and diphtheria due
to immunizations; large reductions in tooth decay resulting from visits on
our Miles of Smiles mobile dental unit; education and treatment that has
dramatically reduced sexually transmitted disease rates; and regulation
that helped ensure safe food and water.This history also reminded me
of the forward-thinking leadership of the Ottawa County Commissioners
and Administration who have supported this department in its mission for
more than 80 years. It reminded me of the people who dedicated their
professional lives to public health, and how their commitment to excellence
continues to rank us as the healthiest county in Michigan.
We’ve come a long way since our department began in 1931, but
as you will see in the pages of this report our work is not complete.
We still need to protect our food and water supply, immunize our children,
stop the spread of diseases (such as Zika and chlamydia), educate
people about healthy behaviors and prepare for new health threats. We
will continue to serve the people of Ottawa County and be committed to
providing efficient, effective and customer-centered services that promote
and protect health.
Sincerely,
Lisa Stefanovsky, M.Ed
Administrative Health Officer
Health Of ficer
Letter from the
A big thank you to the OCDPH team and community members who contributed to this publication.
Your stories speak volumes, touch lives and make a difference - Editor Kristina Wieghmink, M.Ed.

Please vaccinate your child.
By Heather J Cole (Rhyse's mom)
Rhyse
can't get
vaccinated.
His body
is too fragile.
Once registration was commenced at the
university, the attendees jangled around
a bit. They were lost at first; feeling
awkward in a room of strangers. Teachers,
moms, engineers, construction workers
and people from all kinds of professions
were represented in each group of
15 people. Each person came loaded
with their life story. A soap-box preaching
and a passion ready to be shared.
Rhyse came home from NICU after
one month from his birth. Genetic
tests were pending results and the
daily battle for Rhyse’s survival began.
Failure to thrive, extreme fatigue,
immature lungs and severely low
platelet levels made a crisis driven
mix that sent us to the hospital again
and again and again. I know it's cliché,
but every day with Rhyse is a celebration
of life.
My time in Iowa was twenty years ago. And
yet one story, one man’s story, is still as
fresh in my mind today as it was then. His
story needed to be written. I wish I could
remember his name and where he was
from. Something that would give a name to
the man behind the story. But I don’t. So I
will call him “Tom.”
Genetic testing came back. It was
Noonan Syndrome; a rare and complex
syndrome that means every single
system in his body has some sort of
defective functioning. The syndrome is
so complex that a team of 13 different
specialists tend to his care, to this day.
Rhyse also has a large mass extending
from his neck down into his lower
organs. Doctors were 99% sure it was
neuroblastoma (a rare type of cancer),
but after days of inpatient tests it was
determined to be something else; an
anomaly they can't figure out.
When I was in my late 20s I attended
a week long writing course at the
University of Iowa. Being summer time,
the weather was stifling hot and muggy;
and the dorms were at least a quarter mile
from the university buildings. Regardless
of the penetrating heat and the broken air
conditioning unit in my room, I was out of
my mind in glory just to be in a place where
other adults from all walks of life had the
same closet passion for writing as I do.
More so, writing with a purpose - even if we
were the only ones in the world who ever
read our words.
Five years ago I gave birth to my son.
The doctor said he was terminal; likely
Leukemia. After being transferred to a
large children’s hospital, my son Rhyse
spent the following month undergoing a
battery of tests, infusions, spinal taps,
bone marrow aspirations and more.
Tom was a middle-aged man bound to a
wheelchair. Tom had been in that wheel-
chair since the massive polio epidemic in
the 40s and 50s. He was one of the 42,173
reported cases during the out break. His life
was forever marred - not only his mobility
but also his every waking moment, his
chances for a career and family and for
just about anything most of us take for
granted. The world of accessibility is more
recent, and for the most part, it is too late
for those struck by the disease sixty some
years ago. In the wake of Tom's trauma, he
was a changed man; an angry man; a man
desperate to get his story told so others
could understand him and others like him.
During his readings he would choke up,
wounded like a war survivor, as he outlined
how polio affected his life then and now.
For seven days, the rest of us in the class
were entranced by his mission to help
the world understand him and his school
buddies who also had polio. We watched
his struggles with accessibility. We listened
to understand when and if he wanted help.
We became champions for his cause - to
bring the community around him a little
closer to his experience and his journey
with polio.
The number of polio, measles, mumps,
rubella, pertussis and even chickenpox
cases have significantly decreased (some
even eradicated). This is from the work of
many scientists and organizations like the
March of Dimes (thanks to FDR who also
had polio). However, it was too late for Tom.
Measles has a long history, documented as
early as the 9th
century.In the decade before
1963 (when a vaccine became available),
nearly all children got measles by the time
they were 15 years of age. It is estimated
3 to 4 million people in the U.S. were
infected each year during that time. In 1963,
John Enders and his colleagues licensed
their now effective vaccine, eliminating
measles in the U.S. by the year 2000. Do
you know how amazing that is? Moms and
dads no longer dreaded diseases like polio
and measles!
Vaccinations have saved countless
children from deadly diseases. I wish they
were mandatory. People who choose not
to vaccinate put not only their communities
at a terrible risk but also every child like
mine at a risk that is life threatening. The
2015 measles outbreak linked to two
Disney theme parks is a prime example.
Among the California patients, 45% were
unvaccinated, 12% had three or less doses
of the measles vaccine and 43% had
unknown vaccination status.
My son starts Kindergarten this fall. My
husband and I are anxious about germ
exposure and the consequences that
befall on Rhyse and our family. These
crises change us. They change our other
kids. They create a household of stress
and fear. We are so blessed to have two
children’s hospitals within a two hour drive
from our home. But our frequent-f lyer trips
to the ER are scary and expose Rhyse to
even more viruses and bacteria.
4 www.miOttawa.org/immunize 52016 Annual Repor t
He depends on your immunizations to help protect him from vaccine preventable diseases.
Many of Rhyse’s hospitalizations stem
from the common cold and flu made life
threatening because of his frail immune
system.In addition, one of his diagnoses
is ulcerative colitis. An autoimmune
disorder that creates a sick, swollen
and bleeding colon. This subjects him
to chronic abdominal pain, cramping
and diarrhea. Once ulcerative colitis
was discovered at the age of three, he
immediately began Remicade infusions
at Mott Children’s Hospital in Ann Arbor
every six weeks (a treatment to reduce
the effects of substances in the body
that can cause inflammation). This is
for life. The side effects? A suppressed
and vulnerable immune system, that
is unable to cope with live vaccines.
Rhyse cannot have the polio or measles
vaccines.
Ottawa County
school-aged children
are NOT up-to-date
with the recommended
number of vaccines
414404 non-medical
10 medical waivers
My son starts
Kindergarten this fall.
My husband and I are
anxious about germ
exposure and the
consequences that
may befall on Rhyse
and our family.
Our voices for
vaccinations must be
louder than those who
are opposed. For those
who oppose have no
idea what they are
risking for not only their
communities, but the
nation as a whole.
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6 www.miOttawa.org/immunize
Giggling together at the beach.
Rhyse with his big sister Leah, who was
adopted while we lived in Kenya and
worked with an orphanage. Hanging out
at the beach was a representation of our
freedom last summer. Free to go whenever
we wanted, armed with his feeding pump
and tons of sunscreen. After last summer,
Rhyse seems more in-tune with kids his
age instead of a just a sick kid.
Click to read more of Rhyse's story.
A common scene at our home.
Rhyse's sister Maggey was five when he
was born. Maggey was traumatized by the
NICU scene, and the following three years
of constant ER visits, hospitalizations and
procedures. I call it "sibling PTSD." On
several mornings for those first four years
(the most intensive years), Maggey woke
up to find Rhyse and I had gone to the ER
again. Or, she would arrive home on the
bus to see our car gone and realize Rhyse
was sick again. Maggey is emotional and
compassionate. The past five years with
Rhyse have left an indelible wound on
her heart. As a result, they have a strong
sibling connection and don't like being
apart. Every six weeks Rhyse and I go to
Mot t Children’s Hospital for his Remicade
infusion overnight, and for brother and
sister - it feels like we went to the moon.
Rhyse on his 5th
birthday.
Despite his life revolving around the medical world,
his passion is saving others. He wants to be a policeman,
tow truck driver and a paramedic when he grows up.
Policemen save people.
Tow truck drivers save broken cars.
Paramedics save hurt people.
This is what he plays all the time.

8 miOttawa.org/miHealth Photos cour tesy of Lisa Huisman Photography8 www.miOttawa.org/CSHCS
Still, you will realize Annah’s speech is dif ficult
to understand. It is one of her biggest barriers
to establishing relationships, giving love,
receiving love, being accepted by her peers and
multiplying the love for life she has within her.
However, Annah has much to tell you, more to
ask you and even more love to give you - if you
are patient with her. Unfortunately, most people
are not patient. The world needs more joy and
the love of life. The world needs what Annah
has to of fer. Yet, when people walk away from
her, because they can’t understand what she said,
they miss receiving such a special gift.
We’ve had many challenges raising a child with
disabilities. Financially, we were overwhelmed
with doctor appointments and unexpected
bills. We turned to the Children’s Special
Health Care Services program at the Ottawa
County Department of Public Health. Through
this program, Annah was referred to the
Family Hope Foundation; where she received
a scholarship for speech therapy. We feel so
blessed to be in Ottawa County. Annah received
the best care available in our community for
her special needs from a variety of health care
professionals. This opportunity enabled Annah
to speak more clearly and establish better
relationships. This support made it possible
for us to provide a stable environment not only
for our daughter but for the rest of our family
as well.
A
signature story tells about an event in
your life that af fects who you are today.
The birth of our daughter is one of my
family’s signature stories.
After a 20-week ultrasound, we did not expect
our baby to live. She had a prenatal condition
that most often gets worse, and leads to
death. Upon hearing this, we started to make
preparations. We sobbed after looking at caskets
that were heartbreakingly small and walked
through cemeteries. But a miracle happened.
Our fourth ultrasound revealed our baby’s
irreversible, often fatal, prenatal condition was
reversed! On December 11, 2000, Annah Rose
Huisman was born—alive! However, a few
moments after her delivery, we found out she
had Down syndrome.
When Annah was little, it was hard for us to not
focus on her disabilities. Over the years as she
grew, and the developmental gap between her
and her peers continued to widen, we learned to
focus on Annah’s abilities. For me, my wife and
our six children, Annah is one of our signature
stories. In many ways, Annah is a typical
teenager. She plays soccer, takes ballet lessons
and she is involved in her church youth group.
When you meet Annah, you may conclude she
has special needs because of her appearance.
You will also see that Annah wants to engage
you in a conversation. She is very sociable. She
will want to know your name and tell you hers.
There is a good chance you will like her, because
she will find a way to make you laugh and
brighten your day. Annah will cause you to feel
good about yourself - she brings out the best in
people. Annah is one of our signature stories.
By Bob Huisman (Annah's dad)
HowspeechtherapyhelpedateenagerwithDownsyndrome.
Annah
if you make time to LISTEN
has much to say ...
Huisman Family
9
Most
people are
impatient
and walk
away from
Annah,
because
they can't
understand
what she
said.
"
"

112016 Annual Repor t10 www.miOttawa.org/food
Inspection Reports at www.miOttawa.org/Food
By Spencer Ballard, REHS
Environmental Health Supervisor
Online restaurant inspection reports give
an establishment's history of violations
(available at www.miOttawa.org/Food), so diners
can make more informed decisions on where to
eat. For an establishment to hold a food license, a
level of compliance must be maintained. However,
licensure and inspections alone do not ensure food
safety. Environmental health specialists (with the
OC DPH Food Services Division) focus on the safety
and sanitation of food and drink items. They do
this through education, audits and enforcement of
the Michigan Food Law. The owners, managers and
employees at food establishments are responsible for
the safety of the foods being prepared and served
each day.
VIOLATION TYPES
Ottawa County food establishments have
unannounced inspections every six months. If
priority or priority foundation violations are found,
then they must be corrected immediately during the
routine inspection. If it is not possible at that time,
there will be a follow-up inspection(s) to ensure
all violations have been resolved. Priority violations
are the highest risk violations which are directly
related to an increased risk of foodborne illnesses
(e.g., improper handwashing and unsafe food
temperatures). Priority foundation violations are
ones that can create a Priority (high risk) violation
(e.g., lack of hand sink soap, calibrated thermometer
or test strips to check sanitizer levels). Core violations
are lower risk violations (e.g., general maintenance of
the facility's floors, walls and ceilings). Corrections
of core violations are verified at the next routine
inspection.
ENFORC EMENT TYPES
When violations repeat at multiple inspections,
or active managerial control is not demonstrated,
enforcement may begin. Establishments are charged
fees for each step within the enforcement process
(amounts are based upon the violation type and
number of occurrences). For repeated core violations
(low risk), a civil citation is issued; starting at $250
and doubles after each inspection if it's the same
core violation. When priority and priority foundation
violation(s) repeat, a Risk Control Plan is requested.
This request serves as a warning to the establishment
and an opportunity for management to demonstrate
active managerial control. If the same violation(s) is
cited again, a compliance conference is held to develop
a Corrective Action Plan. If the same violation(s) keep
occurring further action is taken; starting with an
administrative consultation. If corrections are still not
made, it may lead to an informal hearing and possibly
a formal hearing; which may ultimately lead to a
revoked license.
CLOSING A RESTAURANT
If an imminent health hazard is found, a restaurant
is immediately and temporarily closed. It may reopen
after a follow-up inspection proves the hazard
has been eliminated. Imminent health hazards are
situations in which the public may be in immediate
danger (e.g., lack of water or electrical power, fire,
flood, sewage back up in the kitchen, severe pest
infestation, significant number of priority and/or
priority foundation violations and a foodborne
illness outbreak).
As patrons are more informed and make decisions
based on inspection report findings, the motivation
of food establishment owners and managers to
comply with the regulations may increase. Ideally,
food establishments that make food safety a daily
priority are rewarded with increased sales; and the
risk of foodborne illness decreases as consumers
become more informed.

12 miOttawa.org/miHealth 132016 Annual Repor t12 www.miOttawa.org/HearingVision
laughter
hearing

smiles
seeing
14 www.miOttawa.org/HearingVision
" "I'm
learning
to be at
school,
said Genavicia
during her hearing
and vision screening.
Watch now.
Undiagnosed
hearing & vision
problems
may interfere
with a child's
development;
affecting their
success in school
and in life.
Audx - screens hair cells in a baby's inner
ear; using clicks or tones to measure echo.
Audiometer - pure tone screening using
a block drop and hand raise technique.
LEA Symbol Cards/Stereo Butterfly -
vision test for preschool children; screens
for stereo acuity and depth perception.
Titmus V3 Vision Screener - tests
visual acuity, binocular vision, depth/
color perception and muscle balance.
SureSight Vision Screener - ensures
early detection of refractive error;
primary vision disorder in children.
Sylvia Wion, Irene Atwood, Mary Hamstra, Esther Arizola,
Janine Chittenden, Monique Carey and Sandy Boven
Many children are unaware they hear and see dif ferently
than their peers. Hearing and vision screening provides
a valuable service for parents, their children and educators as
the ability to see and hear aids in ability to learn. This is key to
a child’s success in school and in life.
We are committed to providing all Ottawa County children
with hearing and vision screenings to ensure they have the
skills necessary to succeed. Our trained technicians follow
state rules and conduct free screening for children in schools,
preschools, Head Starts and here in our clinics. We know
with early detection and treatment we can help children with
speech, language and social development. This is why we
regularly follow them throughout their school experience.
Through providing some 40,000 screens each year, we find
nearly 10 percent of children are in need of further medical
attention for vision and three percent for hearing. Last year,
more than 2,200 children were referred to specialists after
not passing their screening. Through medical treatment,
children have improved sight and ability to hear clearer.
This leads to being better prepared to learn, to speak and to
socialize; improving health and developmental outcomes.
Our vision is for healthy people, and the hearing and
vision screening program is true public health in action.
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By Janine Chittenden, BSN, RN
Child Health Team Supervisor

16 miOttawa.org/miHealth
I cried at my son’s hospital bed - for his well-being and worried about how we were going to pay for his care and keep up with bills.
THANK
YOU
16 www.miOttawa.org/MIHP
By Devon Stuit,
Community Health Clerk
son needed for his seizures. Since she was still
working on getting health insurance coverage,
she had to reschedule the children’s hospital
appointment again. I encouraged her to keep
pressing forward with the process. We filled out
the additional paperwork and I walked it over
to the nearby DHHS of fice myself to make sure
they received it with plenty of processing time
before her son’s appointment.
Two weeks later, the mother came to my of fice
extremely happy! She finally received Medicaid
for her son and took him to the children’s
hospital. His medical bills were covered by the
health insurance plan. She presented me with
the most adorable card with her son’s footprint
on it and their heartfelt thank you.
This past July, I met with a mother who
recently moved to Ottawa County from
out of state with her husband and their son. She
told me her son was admitted to the hospital
for seizures, but they were not able to diagnose
him; so they referred him to a children’s
hospital. Her son’s appointment was scheduled
a few weeks out, and they did not have health
insurance coverage. Her husband was working
as a sub-contractor without health insurance
and they were not able to pay out of pocket
medical costs. They had limited income and her
husband was not getting paid the amount he
was promised. She came to our Holland of fice
for help signing up for Medicaid.
I helped the mother fill out the application
and I stated they may need to send additional
information, if asked by the Department of
Health and Human Services (DHHS). The
mother came to me again a couple weeks later
stating they did receive a letter requesting
additional information. Together we called
her caseworker.
However, too much time passed and a new
application was required. Meanwhile, her
son had been back in the hospital with more
seizures. We filled out the application again,
along with providing verification of income
and the additional information requirements.
I called and explained to the DHHS caseworker
the family’s situation. Their son had multiple
hospital visits and the husband already asked his
employer for pay advances, which did not help
them get ahead.
Shortly after the application was resubmitted,
they received another letter asking for more
information. The mother came in to see me
again. She was frustrated and considered leaving
Michigan just so they could get the help her
Some people may not understand the struggles that come with not having health insurance.

18 miOttawa.org/miHealth 192016 Annual Repor t18 www.miOttawa.org/BeachWatch
Are Ottawa County beac hes
?
ImagecourtesyofKaylaAnderson-BeachatWindsnestPark(OttawaCounty,MI)

20 miOttawa.org/miHealth 212016 Annual Repor t2020
Water Sampling
During the 2016 summer, I conducted
weekly on-site sanitary surveys at the Grand
Haven City Beach, Grand Haven State
Park, Holland State Park, Tunnel Park and
Windsnest Park as part of the Beach Watch
program. Surveying consists of assessing
general beach conditions, water quality
conditions, bather load and potential
pollution sources at three locations within
the swimming area (left, middle and right).
5beaches were tested weekly
during the summer for E. coli.
First, I assessed water quality conditions
through a visual inspection (pictured here).
I examined the water color and clarity, along
with determining if any odor existed. If
such conditions were ever present, then it is
indicative of potential pollution. After each
visual inspection I completed, I collected
water samples (pictured on the next page)
to test for E. coli - a type of bacteria found
in intestines of animals and humans.
If the results of the three test samples
average to less than 300 E. coli per 100
milliliters of water, then there is less risk
of recreational water illnesses. Higher levels
of E. coli indicate fecal contamination
and the possible presence of other harmful
bacteria, parasites and viruses in the water.
" One aspect I value the most
about my job is the opportunity
to work within communities to
protect public health.
"
By Kayla Anderson, BS
Environmental Health Technician
www.miOttawa.org/BeachWatch 212016 Annual Repor t
Tunnel Park (Ottawa County, Michigan)
Results posted at miOttawa.org/BeachWatch
Low risk if <300 E. coli per 100 ml of water
Natural bodies of water contain microorganisms,
regardless of how clean or clear the water may
look. Exposure to beach water with high levels
of microbial contamination (300 E. coli per
100 milliliters of water or more) may increase
the risk of ear, eye, nose and throat infections;
gastrointestinal illness; or skin rashes. It may also
lead to parasitic infections.
According to the Centers for Disease Control
and Prevention, pathogens that cause recreational
water illnesses are spread by swallowing, breathing
in the mists or aerosols from, or having contact
with contaminated water in swimming pools, hot
tubs, interactive fountains, water parks, lakes,
rivers, or oceans.
Water may become contaminated by:
• animal waste,
• rain and agricultural runof f,
• faulty septic systems,
• sewer overf lows,
• manufacturing processes,
• naturally occurring chemicals and minerals,
• and local land use practices
(fertilizers and pesticides).
contaminated
How water becomes
• Do not feed the birds.
• Keep pets of f the beach.
• Use the restroom before swimming.
• Do not swallow lake water.
• Wash your hands with soap and water before eating.
• Do not swim in water that smells foul.
• Shower when you return home.
• Avoid swimming immediately after heavy rainfall.
Prevent Sickness
Beac hes
everywhere, and at all times,
have microorganisms
which can cause illness.
6

22 www.miOttawa.org/DiseaseInfo
ZIKA
Virus
Zika is spread mostly by the bite of
an infected Aedes species mosquito.
Mosquitoes that spread Zika virus also
spread dengue and chikungunya viruses.
These mosquitoes are aggressive daytime
biters and can also bite at night. The Aedes
species mosquito is not native to Michigan
but in southern states, Mexico, Central
America and South America. Zika can also
be passed through sex from a person who
has Zika to his or her sex partner(s).
Zika is linked to birth defects.
Zika can be passed from a pregnant woman
to her fetus. Infection during pregnancy
can cause serious birth defects, including
microcephaly (a birth defect in which infants
are born with abnormally small heads and
brain damage). Pregnant women should not
travel to areas with Zika. If travel to one of
these areas is a must, they should talk with
their health care provider first and strictly
follow steps to prevent mosquito bites. If a
pregnant woman has a partner who lives
in or has traveled to an area with Zika, she
should not have sex (or use condoms every
time during pregnancy).
Prevent Zika by avoiding bites.
If traveling to areas outside of Michigan
that have the Aedes species mosquito.
• Use insect repellent.
• Wear long-sleeved shirts and long pants.
• Stay in places with air conditioning or
window and door screens.
Travel related - No pregnant women
10 cases
Ot tawa Count y
By Tamara S. Drake, MPH, RN
Communicable Disease Clinic Supervisor
Zika can be passed through sex.
Travelers returning from areas af fected by Zika
should use condoms or not have sex if they are
concerned about passing Zika to their partners.
Zika can be passed through sex even if the
infected person does not have symptoms at the
time. Studies are underway to find out how long
the virus stays in the semen and vaginal f luids of
people who have Zika and how long it can be
passed to sex partners.
There is no vaccine or medicine.
Scientists are working on developing a vaccine
for Zika. The best way to prevent it is by avoiding
bites from the Aedes mosquito (not found in
Michigan). Before travel to any area, find out
what vaccines are available for other vector-borne
diseases or vaccine preventable diseases. Contact
the OCDPH Travel Clinic for more information
about available vaccines and the CDC's travel
recommendations at (616)396-5266 or visit
www.miOttawa.org/travel.
The LIFETIME COST to care
for a child with birth defects
can be or more.
10million
$
Zika cases in Ottawa County (as of August, 2016).
OCDPH Epidemiologist Marcia Mansaray, M.Sc.
interview with WZZM13 on 09/14/2016.
7
8
9

Expands Ser vices to Adults
24 www.miOttawa.org/dental
Maranda with WOTV4women interviews Miles of Smiles
at an Ottawa County school on May 10, 2016.
By Debra Bassett RDH, BHS
Oral Health Team Supervisor
For 22 years, the OCDPH Miles of Smiles (MOS)
mobile dental unit has provided dental services
to Ottawa County children who are uninsured or
underinsured. In 2013, the Michigan Healthy Kids
Dental Medicaid enhanced its reimbursement rate;
thereby increasing the number of dentists who
accept this insurance. By children having greater
access to dentists, there was a decrease in the
number of children serviced by MOS. As a result,
in March 2016, MOS expanded its dental services
to Ottawa County adults in need.
Providing dental services for Ottawa County
children at schools is an ongoing goal - and now,
by collaborating with OCDPH's Maternal Infant
Health Program; the Holland Free Health Clinic
(HFHC); and the Holland Rescue Mission (HRM)
the OCDPH can also provide dental health services
for Ottawa County adults. The mobile unit parks
outside the HFHC at least twice a month and at the
HRM at least once every quarter. In addition, with
MOS being a mobile unit, we help overcome the
need for transportation that can be a barrier for
many low income residents.
According to the CDC, oral health has
been linked with other chronic diseases,
like diabetes and heart disease.
FACTS: The 2015 Ottawa County Health Needs
Assessment states nearly 5 7 percent of key informants
reported Ottawa County lacks in programs such as
dental, mental health and primary care for low income
residents. The 2014 Ottawa County Behavioral Risk
Factor Survey states nearly a quarter of Ottawa
County adults surveyed are not exercising preventive
oral health care (i.e., have not visited the dentist in the
past year for a teeth cleaning).
1,355
KIDS
153
ADULTS
Volunteer DENTIST
provided services
operational days
out of
53
109
$46,254
Received in
GRANTS &
DONATIONS
1,083
Exams
TOTAL
1,508
MOS Appointments
709
Sealants
977
Cleanings
835
Fillings
957
Fluoride
Varnish
Applications
10
11
12

The Flint
water crisis
brought
at tention
to the
devastating
ef fects lead
poisoning
can have on
children.
childhoodLEAD EXPOSURE
Children can be given a blood test to measure
the level of lead in their blood. Until recently,
children were identified as having a blood lead
level of concern if the test result was 10 or
more micrograms per deciliter (µg/dl) of lead
in blood. In 2012, the CDC recommended the
definition of lead poisoning change from 10
to 5 µg/dl. Michigan changed their reporting
in 2014. In the past, blood lead level tests
less than 10 µg/dl may, or may not, have been
reported to parents. The new, lower value
means that more children likely will be
identified as having lead exposure allowing
parents, doctors, public health of f icials and
communities to take action earlier to reduce
the child’s future exposure to lead.
In accordance with program policy, all Medicaid
covered and WIC enrolled children should
be tested for blood lead at 12 and 24 months
of age. All children ages one to six should be
screened annually for blood lead risk and tested
as necessary. If a capillary test result is ≥ 5 µg/
dl, then the child should have a follow-up
venous test. If a venous test result is ≥ 5 µg/
dl, then the child should follow the medical
recommendations.
Blood Lead Levels
Health Ef fects of Lead
CHILDREN six years old and younger
are most susceptible to the ef fects of lead
because their growing bodies absorb more lead
than adults do and their brains and nervous
systems are more sensitive to the damaging
ef fects of lead. Babies and young children can
also be more highly exposed to lead because they
often put their hands and other objects that can
have lead from dust or soil on them into their
mouths. Children may also be exposed to lead
by eating and drinking food or water containing
lead or from dishes or glasses that contain lead;
inhaling lead dust from lead-based paint or
lead-contaminated soil; or from playing with
toys with lead paint. Because symptoms may
occur slowly or may be caused by other things,
lead poisoning can be easily overlooked. Lead
can af fect almost every organ and system in the
body. Even low levels of lead in the blood of
children can result in:
• slowed growth;
• anemia;
• behavior and learning problems;
• lower IQ and hyperactivity;
• hearing problems;
• and in rare cases, ingestion of lead can
cause seizures, coma and even death.
Adults may also be exposed to lead by breathing
lead dust from spending time in areas where
lead-based paint is deteriorating, and during
renovation or repair work that disturbs painted
surfaces in older homes and buildings. Working
in a job or engaging in hobbies where lead
is used, such as making stained glass, can
increase exposure as can certain folk remedies
containing lead. Adults exposed to lead can
suf fer from cardiovascular ef fects, increased
blood pressure and incidence of hypertension,
decreased kidney function, and reproductive
problems. A pregnant woman’s exposure to lead
is of particular concern because it can result in
exposure to her developing baby.
By Adeline Hambley, MBA, REHS
Environmental Health Manager
14
13

Lead dust can also be tracked into a home
from soil outside that is contaminated by
deteriorated exterior lead-based paint or
from working an occupation where lead
is used. Shoes should be wiped on mats
or removed before entering a home to
control lead. In addition, homes built
before 1986 are more likely to have
lead pipes, fixtures and solder. Lead can
enter drinking water through corrosion
of plumbing materials, especially where
the water has high acidity or low mineral
content that corrodes pipes and fixtures.
To address corrosion of lead and copper
into drinking water, the EPA issued the
Lead and Copper Rule (LCR) under the
authority of the Safe Drinking Water
Act. The LCR requires corrosion control
treatment to prevent lead and copper from
contaminating drinking water. Corrosion
control treatment means systems must
make drinking water less corrosive to the
materials it comes into contact with on
its way to consumers' taps.
Older Homes
Lead from paint, including lead-
contaminated dust, is one of the most
common causes of lead poisoning. In
1978, the federal government banned
consumer uses of lead-containing paint.
However, lead paint is still present in
millions of homes; sometimes under
layers of newer paint. Deteriorating lead-
based paint (peeling, chipping, cracking,
damaged or damp) is a hazard and needs
to be cleaned immediately. It is especially
hazardous when found on surfaces that
children can chew or that get a lot of
wear-and-tear; such as windows and
window sills, doors and door frames,
railings, stairs and porches. Common
renovation activities like sanding, cutting
and demolition can create hazardous lead
dust and chips by disturbing lead-based
paint. These can be harmful to adults and
children. Renovation activities should be
performed by certified renovators who are
trained to follow lead-safe work practices.
Lead is a naturally occurring element
found in small amounts in the earth’s
crust. While it has some beneficial uses,
it can be toxic to humans and animals.
Lead can be found in all parts of the
environment (air, soil, water and even
inside homes). Exposure to lead comes
mainly from human activities or contact
with items that contain lead or lead
compounds; such as solders, gasoline,
batteries, ammunition, paint in homes
built before 1978, pipes and plumbing
materials, dishes, imported items (clay
pots and home remedies) and certain
consumer products (candies, make-up,
toys and jewelry).
Sources of Lead
Percentage of homes likely to contain lead-based paint
Yearhomewasbuilt
Between
1960-1977
Between
1940-1959
Before
1940
0 10 20 30 40 50 60 70 80 90 100
87%
69%
24%
tes ted for lead poisoning.
13.5%Only
of Ot tawa County children
younger than yrs were6
Eligible Medicaid covered
kids are not tested by age 3.
NOT
tested1 3out of
- Administrative Health Of f icer Lisa Stefanovsky, M.Ed
Our community pulled together
and took action to better protect
our kids from lead poisoning.
"
"
The Flint water crisis brought attention
to the devastating ef fects lead poisoning
can have on children. This unfortunate
event opened up conversations in our
community on how to better protect
our children from lead poisoning.
Leaders from the OCDPH met with
other concerned health professionals,
educators and government of f icials to
understand the scope and severity of
lead issues in Holland; and ultimately
the whole county. As a result, a Lead
Technical Committee was formed to
share information and resources to
research topics related to elevated blood
lead levels (EBLLs); including sources of
lead in the environment, lead exposure,
health ef fects, impact of lead on learning
and protocols for identifying children
with EBLLs.
In May 2016, the committee released its
findings and recommendations in the
Childhood Lead Exposure and Prevention
in the City of Holland (49423) Full
Report. Some of the findings, as it relates
to Ottawa County as a whole, include:
• It is important to recognize the
dangers lead poses to children
and the pathways of lead exposure.
• While there are specified testing
requirements for children receiving
Medicaid and WIC, there are not
any for other children six years and
younger (only recommendations).
• Children with an initial capillary
(blood from a finger poke) EBLL
are not consistently receiving a
confirmatory venous test (blood
drawn from a vein).
• It is unclear how many children
identified with an EBLL receive
an environmental assessment.
Recommendations for the community:
• Further investigation is needed
to determine why children meeting
the criteria for lead testing are not
being tested.
• Implement a comprehensive
approach to screening and follow
up for children younger than six,
through collaboration of health
care providers, health plans and
local and state agencies.
• Identify strategies which increase
the number of confirmatory venous
tests completed.
• Complete annual lead level
surveillance to monitor for
changes and trends.
• Collaborate to improve nutrition
of at risk children to reduce the
possibility of lead absorption.
• Promote testing of homes and
programs to address lead concerns.
• Increase education and community
awareness about lead exposure and
prevention.
Taking this into account, the OCDPH
formed a team to assess the process of
how the department handles and follows
up with lead cases. They developed a
Primary Care Provider (PCP) survey to
gain a better understanding of physicians’
perspectives of the OCDPH; the role
they expect it to have; and the challenges
PCPs face when testing, reporting and
providing treatment for a child who has
an EBLL. The survey indicated there
have been inconsistencies regarding
how potential lead exposure cases were
handled, when to follow up with a
venous test (after a capillary test) and
how to better educate parents and the
community about lead testing.
The OCDPH managed lead exposure
cases and conducted environmental
assessments for children with EBLLs up
until 2010 when the State of Michigan
changed its equipment requirements and
technician certifications; causing these
services to become cost prohibitive. As
a result, OCDPH requested that the
state provide case management and
environmental assessments through its
Childhood Lead Poisoning Prevention
and the Michigan Healthy Homes
programs.
In 2016, as a result of the Flint water crisis,
thestatenowallowsleadcasemanagement
to be a Medicaid reimbursable service.
This enabled OCDPH to work on
developing processes and programs to
partner closer with PCPs and community
members, with the goal of increasing lead
testing for all Ottawa County children
younger than six.
Our children
15
16
17
18

30 www.miOttawa.org/miHealth 312016 Annual Repor t
PublicHealthAlumna
By Shannon Felgner, Ottawa County Communications Manager
Af ter 15 years working in the f ield of
public health, leaving the post doesn't
dismiss the desire to prevent disease;
protect the environment; or promote
f itness. I get a f lu vaccine. I recycle. I
choose healthy foods. I exercise. One
could say it runs in my veins. I was
thrilled when the opportunity to direct a
running event was placed before me.
In 2016, my colleagues and I had the
opportunity to hold the second annual
M23.1k Run & Relay on the new M231
Highway. The run was initially approved as a one-time affair in
2015. However, it proved to be so popular and successful that
leaders agreed to continue. The purposes of the event are to
raise funds for the Grand Connection non-motorized pathway,
promote paved trails, advocate for wellness, build community
and increase support for Ottawa County government. T hanks
to generous sponsors, runners and volunteers; the events raised
more than $18,000 for the Grand Connection West Michigan’s
system of paved bike paths.
Runs in my veins
Healthy living
Hazardous waste
CONTAMINATES
groundwater
Drinking
contaminated water
can cause serious
health ef fects.
Properly dispose and recycle.
Find your service location at www.miOttawa.org/eco
77,909 lbs of household hazardous waste collected • 8,240 gal of oil/antifreeze recycled
14,171 customers • 2,670 yd3
recycled • 2,090 lbs of electronics recycled in 2016.
Hemlock Crossing in West Olive pictured

VISION
An available
supply of
well-balanced
meals for all.
32 www.OttawaFood.org 332016 Annual Repor t
Work is being done to expand the gleaning
program at the Grand Haven Farmers Market
with The Chamber of Commerce of Grand
Haven, Spring Lake, and Ferrysburg. Gleaning
involves collecting excess fresh foods from
the market and providing it to people in need.
In 2016, more than 2,500 pounds of produce
were collected and distributed to Love in
Action of the Tri-Cities, Community Action
House, Community Action Agency, and Teen
Challenge. The program was made possible
by the market and farmers from Diemer Farm
& Greenhouse, Greenrock Farm, Groundswell
Community Farm,
Ham Family Farm,
Jobey’s Greenhouse,
Krause Farms,
Lakeside Orchards,
Ter Avest Farms, and
Visser Farms.
Gleaning Program
The OCFPC is working to increase the number
of Ottawa County children who receive free
summer meals by expanding, enhancing,
and promoting Meet Up and Eat Up (MUEU)
sites. The goal of MUEU (also known as the
Summer Food
Service Program)
is to provide free
nutritious meals
in the summer to
children who rely
on school food.
Each year, the
program grows more
successful. In 2016,
more than 14,000
meals were served
from OCFPC partner sites. This is a significant
increase compared to 2015 (5,534 meals)
and 2014 (412 meals). Pictured is a site in
Grand Haven.
Meet Up and Eat Up
Action
Turning plans into
The Prescription for Health (PFH) program
was designed to encourage fresh fruit and
vegetable consumption for low income
individuals with chronic disease. People
are referred to the program by their health
care provider to help address conditions
such as diabetes, high blood pressure, high
cholesterol, heart disease, and obesity. PFH
participants can attend the farmers market
up to 10 times throughout the market
season. At each visit, they receive tokens for
$10 to purchase fresh fruits and vegetables.
During the 2016 market season, there were
50 participants: totaling 373 market visits!
The PFH program is a collaborative effort
between OCDPH, OCFPC, North Ottawa
Community Health System, North Ottawa
Medical Group, Love in Action of the
Tri-Cities, Tri-Cities YMCA, Michigan State
University Extension, and The Chamber of
Commerce of Grand Haven, Spring Lake
and Ferrysburg. Funding is provided by the
Grand Haven Area Community Foundation
(Healthy Seniors Healthy Youth Endowment
Fund) and the Marion A. and Ruth K.
Sherwood Family Fund.
Prescription for Health
Farmers market visitors donated fresh fruits
and vegetables to local pantries while they
shopped at the Grand Haven Farmers Market
and the Spring Lake Farm and Garden Market.
This program was coordinated by the OCFPC
and The Chamber of Commerce of Grand
Haven, Spring Lake, and Ferrysburg. Shoppers
were encouraged to purchase extra produce
at the market, and drop it off at the OCFPC
donation table. Volunteers from The Salvation
Army of Grand Haven, The People Center
in Spring Lake, and Love INC of the Tri-Cities
staffed the table during the market season;
and distributed the donated produce to
clients at their respective food pantries.
Food Donation Program
T
he Ottawa County Food Policy Council
(OCFPC) is a collaboration of more
than 40 local agencies and individuals
who work to ensure all Ottawa County
residents have access to healthy, local,
and affordable food choices. The council
began in 2011, and consists of members
from a variety of backgrounds; including
local public health, United Way, food
pantries, human service organizations, food
security advocates, MSU Extension, Feeding
America West Michigan, farmers, and many
others. The OCFPC also has a Consumer
Advisory Committee; consisting of food
resource users who offer suggestions to
help with future initiatives.
After extensive collecting and reviewing of
data; council members identified themes,
developed strategies, and established
3priority areas.
The Prescription for Health, Meet Up and Eat
Up, Food Donation, and Gleaning programs
featured here are a part of the OCFPC's
Strategic Plan - turning plans into actions.
• Eliminate hunger in Ottawa County.
• Healthy eating by all.
• Increase sourcing of local food.
ByLisaUganski,RD,MPH(Dietitian/HealthEducator)andAmySheele(HealthEducator)

34 www.miOttawa.org/nutrition
Ac ross
County LinesBy Amy Sheele, Health Educator
Agrant from the Michigan Department of
Health and Human Services made it possible
for the OCDPH and the Allegan County Health
Department to partner, form new relationships
and identify similar health needs and priorities
across county lines. Within the 6 month grant
period, we focused on three areas; physical
activity, nutrition and sexual health. We developed
a comprehensive marketing campaign to promote
our joint efforts and share the resources
produced as a result of this grant. Outreach
included magazine, newspaper and radio ads;
bus billboards; banners at fairgrounds; social
media posts; email marketing; and distributing
flyers, guides and educational materials to both
communities.
This grant enabled us to address health issues
across county lines. The relationships formed are
important for future cross-jurisdictional sharing.
" "
ImagecourtesyofOttawaCountyParks,PinkLady'sSlipperfloweratRileyTrails.

36 www.miOttawa.org/parks
Physical Activity
The Allegan and Ottawa County health
departments and the Allegan and Ottawa
County parks departments coordinated
with the Ottawa County Geographic
Information System (GIS) department to
map out featured trails in both counties.
The information was used to create trail
guides, which aided participants in the
Step It Up! Walking Challenge.
The Allegan County Featured Trails guide
provides satellite images with suggested
routes at Bysterveld Park, the Allegan
Sports Complex, New Richmond Bridge
Park and the Outdoor Discovery Center
Nature Preserve. The Ottawa County
Featured Trails guide provides satellite
images with suggested routes at Paw
Paw Park, Grand Ravines Park, Hemlock
Crossing and the Rosy Mound Natural
Area. The guides also contain information
about park accommodations and hours,
trail tips and a health message about ticks
and diseases. The guides (English and
Spanish) were distributed throughout the
health and parks departments, tourism
locations, Chamber of Commerce offices
and to participants of the Step It Up!
Walking Challenge.
The challenge was created to motivate
people to be physically active by
walking 225 miles during a seven week
period. Every step taken throughout the
challenge counted toward their goal.
The 225 mile challenge represented a
virtual hike along a Michigan
segment of the North Country
Trail in the Upper Peninsula.
Participants were able to login
and record their weekly activity
to track their progress by using
an interactive map created by
the GIS department.
To encourage physical activity and park
visits, participants were invited to weekly
group walks led by parks naturalist
guides. More than 100 people joined the
first Ottawa County group walk. In seven
weeks, 404 people participated in the
challenge; walking 71,174 miles. That’s
virtually walking the entire North Country
Trail (4,600 miles) more than 15 times!
In a survey sent after the completion
of the challenge, nearly 40 percent
reported an increase in their level of
physical activity from the beginning
of the challenge to the end. "This is a
great example of collaboration in our
local government. Many departments
and community members in Allegan
and Ottawa County worked to create
enjoyable and healthy activities together,"
said Jessica VanGinhoven with Ottawa
County Parks & Recreation. Healthy living
is just one step away!
Guided walk at Grand Ravines Park
Click to hear more about the challenge.
(Continued)
Across County Lines
Nutrition
The grant enabled us to bring more than
2,000 MyPlates (a USDA initiative) to the
counties. In Allegan, more than 1,000
plates were given at an early childhood
carnival and in preschool classrooms.
In Ottawa, more than 1,000 plates were
given at farmers markets and Meet Up
and Eat Up sites (a program designed to
ensure children receive healthy meals
throughout the summer). The MyPlates
were accompanied by nutrition education,
games and activities.
In addition, we created Fresh Food
guides (English and Spanish) with the
Ottawa County Food Policy Council and
the Healthy Allegan County Coalition to
help people find healthy, local and fresh
foods at farm stands, farmers markets
and U-pick locations. The guides included
information about which food programs
were accepted as payment (Bridge Cards,
Double Up Food Bucks, WIC Project
FRESH and Senior Project FRESH) at each
of the locations listed. We distributed
5,500 guides to local farm stands, farmers
markets, Feeding America West Michigan
and partnering agencies.
(Continued on page 38)

38 www.miOttawa.org/WearOne 392016 Annual Repor t
(Continued)
Across County Lines
&
Sex Ed
STD Testing
in Schools
Chlamydia is on the rise in Ottawa
County. To help combat this, OCDPH
provided sexual health education and
school-based STD testing to four alternative
education high schools in 2016. Nearly
200 Ottawa County students (14-19 years
of age) received health education from an
OCDPH certified sexuality educator, who
focused on STD prevention. Of these 200
students, more than 50 elected to have free
and confidential STD testing. Registered
nurses from OCDPH facilitated the on-site
testing. Participants who tested positive
for chlamydia were offered free treatment
and partner notification information.
Several students voiced their appreciation
of having on-site testing and increased
access to health. This is a fine example of
brining public health services out into the
community. This initiative will continue in
2017, where more schools will be added.
As part of the grant from the Michigan
Department of Health and Human Services
(pages 34-37), the OCDPH partnered with
the Allegan County Health Department
and Ottawa County GIS to map locations of
positive chlamydia cases in Allegan County.
The OCDPH was already mapping cases in
Ottawa County since 2013, which resulted
in the development of the Wear One
program. This condom availability program
and sexual health education campaign was
designed to address the increasing rates of
chlamydia among 18-24 year old individuals
in Ottawa County. Funding from this grant
enabled OCDPH to expand Wear One
across county lines.
Using the GIS maps, health educators
focused on areas in the counties where
the number of chlamydia cases were the
highest. They worked with 18 surrounding
businesses and establishments in Allegan
County (such as health clinics, restaurants,
gas stations, retailers, tattoo parlors and
more) and provided them with free Wear
One bags. Each bag included condoms,
lubricant and cards containing information
about sexual health and STD testing
services. Between the two counties, nearly
50 locations distributed more than 43,000
condoms (during the grant period).
This cross-jurisdictional sharing opportunity
and the community partnerships enabled
the counties to focus on common goals;
creating sexual health awareness,
increasing free condom availability and
working to decrease sexually transmitted
diseases.
Sexual Health
ByHeatherAlberda,BA,AASECTCer tifiedSexualityEducator
By Connie Kross, BSN, RN, Family Planning & STD Team Supervisor

40 www.miOttawa.org/2015YAS
• A locally developed teen survey - www.miOttawa.org/2015YAS.
• Conducted every two years at grades 8, 10 and 12 in participating
Ottawa County schools.
• Monitors how behaviors increase, decrease or stay the same over time.
• Measures how many teens are engaged in a wide variety of both
risky and beneficial behaviors that affect their health and well-being.
• This report data was collected from October, 2015 through early
December, 2015; and published in April 2016.
• Planning and implementation of this study was coordinated by the
YAS Committee, with a special thank you to the funders, school district
superintendents, school principals, administrators, teachers, parents
and students.
What is the YAS?
• Provides evidence-based information about what the biggest
needs are (and aren’t) among Ottawa County teens.
• Gives parents information they may use to guide their teens in
becoming physically, emotionally and mentally healthy adults.
• Helps schools, local agencies and faith communities focus their
efforts on the most pressing and prevalent issues teens say they face.
• Helps evaluate the effectiveness of interventions developed
to address pressing and prevalent teen issues.
• Organizations and community members may request
additional analysis that is suited to fit their needs.
Why is the YAS important?
youth assessment survey
YAS
Ottawa County
2015
Released in2016
By Marcia Mansaray, M.Sc
Epidemiologist
Participants
4,966
par ticipants
50% male
50% female
75% White
11% Hispanic
14% Other
8th
grade 46% 10th
grade 31% 12th
grade 23%
3,170
participants
answered
sexual health
questions
Average Age of Onset
Average age 12th
graders first engaged in behavior
Joined an organized gang
Smoked cigarettes
Used chewing tobacco
Used electronic vaping products
Drank alcohol
Used marijuana
Used inhalants to get high
Misused over the counter drugs
Misused prescription drugs
Had oral sex
Had sexual intercourse
11
14 1/2
15
15 3/4
14 3/4
15
13 1/2
14 1/4
14 3/4
15 1/2
15 1/2
• Questions about:
• family and school experiences;
• sexting and sexual behaviors;
• mental health conditions;
• bullying, safety and violence;
• alcohol, tobacco and drug use;
• body image, nutrition and physical activity;
• and many more.
• New questions in 2015:
• bullied in neighborhood;
• use of electronic vapor products;
• using another ID to buy alcohol;
• recently used different forms of marijuana;
• have parents who talked about expectations when it comes to sex;
• and tested for a sexually transmitted disease in the past year.
• What issue areas affect males and females differently.
• Ages when teens may engage in risky behaviors for the first time.
What is in the YAS report?
"
"
The YAS gives me
real data and
talking points for
my discussions with
staff and parents.
It's real because it's
local. These are our
students, and the
information enables
us to make informed
decisions on how
to help change
behaviors.
- Superintendent Cal De Kuiper,
Zeeland Public Schools

42 www.miOttawa.org/SAP
Serving, Selling and Drinking
We support establishments in
their effort to responsibly serve
and sell alcohol and tobacco.
Our partnerships are critical to
the success of this program.
PREVENT SALES TO MINORS
By Rebecca Young, BA
Health Promotions Team Supervisor
In the summer of 2016, the OCDPH (along with
the ROADD Coalition) created a campaign to
promote the Mobile Eyes initiative. The message
was designed to encourage motorists to call 911
if they see someone drinking while driving, if a
car is swerving or violating traf f ic signals or if
someone is visibly intoxicated walking to his/her
car to drive. Callers are to explain the reason for
the call and give a vehicle description, license
plate number and the location.
Several methods were used to help bring
awareness. The OCDPH (and partners) created
and distributed 5,000 f lyers, 750 vehicle air
fresheners and 350 pens. We had campaign
banners up at the Hudsonville Community
Fair and the Ottawa County Fair. We also had
billboards along major highway routes, on buses
and at the Georgetown Ice Arena. In addition, we
placed ads in entertainment magazines and at
alcohol serving establishments throughout
West Michigan. It is estimated this campaign
reached more than a million people.
STOP DRUNK DRIVING
The OCDPH works with the Ottawa County
Sherif f’s Of f ice, Holland Police Department
and Grand Haven Police Department who
recruit and train underage youth to go into
establishments that sell alcohol and/or tobacco
to attempt to make a purchase. These law
enforcement compliance checks are an ongoing
ef fort in Ottawa County to prevent the sale
of alcohol and tobacco to minors. They help
identify areas within the county that may need
Health educators in the Substance
Abuse Prevention Program address
underage access to alcohol and tobacco,
along with alcohol related crashes among
18-24 year old individuals. Funding for this
program is provided through Lakeshore
Regional Entity and comes from the Michigan
Department of Health and Human Services/
Bureau of Community Based Services, Office
of Recovery Oriented Systems of Care. The
OCDPH works closely with Ottawa County
alcohol and tobacco retailers, law enforcement
and other prevention agencies to address these
issues through education and enforcement.
EDUCATE SERVERS AND RETAILERS
Each year, OCDPH holds an event for people
who serve or sell alcohol in West Michigan.
A representative from the Michigan Liquor
Control Commission (MLCC) presents updates
and changes regarding liquor laws. It is a great
opportunity for attendees to ask questions
and get clarif ication on the laws. In 2016,
46 people from 29 establishments attended.
To help retailers and servers minimize the
legal and safety risks associated with alcohol
misuse, we offer a nationally recognized
certif ication program called TIPS®
(Training
for Intervention ProcedureS). In 2016, 194
alcohol servers from 21 establishments were
trained.
additional support, education and monitoring.
The checks serve as a reminder for retailers
to be diligent with regard to checking IDs.
They are also a tool to help identify needs
for additional staff training.
The locations that do not pass the alcohol
checks receive a f ine, and so do the staf f
member(s) who sold the alcohol. The MLCC
is also notified of the alcohol sale. For the
locations that do not pass the tobacco checks,
the clerk is f ined and the MLCC is notif ied if the
establishment also sells alcohol. In 2016, the
checks averaged an 85% compliance rate. The
OCDPH also conducted vendor education site
visits at 166 alcohol and 130 tobacco retailers,
where information about ID checking, staf f
training and policies regarding sales to minors
was given.

44 www.miOttawa.org/Prepare 452016 Annual Repor t
Law enforcement officers
and first responders on-site.
Line of people seeking treatment.
Registration table to fill out
forms for treatment.
On-site clinic overseen by medical
director and nurse supervisors.
Health screenings by registered nurses.
Medication dispensing station.
First aid and EMT available.
Patient health education.
Incident team reported to duty
and directed to stations.
PREPAREDNESS
and RESPONSE to a
Biological
Outbreak
Emergency
preparedness
is a team sport
- Executive Vice-president Eric Whitaker
University of Chicago Medical Center
“
”
By Jennifer Sorek, MA, MEP
Public Health Preparedness Coordinator
Responding as a team and collaborating
with partners is critical in public health
emergencies. Whether influenza is on the
rise, Ebola is crossing borders or Zika is
impacting health - preparedness is the key!
To test its preparedness and emergency
response capabilities, the OCDPH
conducted a full-scale open Point of
Dispensing (POD) exercise to respond
to a simulated anthrax exposure. A POD
is an identified location that can be used
for distributing medications or vaccines
to a large number of people in the event
of a public health emergency. The OCDPH
worked with the Ottawa County Facilities
Maintenance Department, Ottawa County
Sheriff's Office, Ottawa County Citizens
Corps and community partners to activate
a POD during July 2016.
More than 100 people participated in the
mock event by planning, setting up the
location, securing the area, providing
the media and public with information,
registering people for treatment, acting
as a patient, conducting health screenings,
dispensing medication, providing health
education or being a first aid responder.
The exercise reinforced the POD process
and flow. It also served as a tool to find
areas for improvement and how to be more
efficient and effective when responding to
a public health emergency.

46 miOttawa.org/miHealth 472016 Annual Repor t
Unaudited
FY12 FY13 FY14 FY15 FY16
Actual Actual Actual Actual Actual
Revenues
Intergovernmental revenues 3,881,638$ 3,065,004$ 3,991,504$ 4,801,365$ 3,585,415$
Charges for Services 671,925 696,758 826,927 918,093 955,244
Licenses & Permits 691,093 769,963 779,766 850,503 906,204
Other 197,529 247,543 217,256 111,055 75,639
Total revenues 5,442,185 4,779,268 5,815,453 6,681,016 5,522,502
Expenditures
Personnel Services 5,891,724 6,001,209 6,099,821 6,275,885 6,375,615
Supplies 1,026,359 948,512 887,349 863,992 906,384
Other services and charges 1,702,686 1,755,616 1,847,066 1,955,692 1,793,395
Capital Outlay - 8,030 - - 7,064
Total Expenditures 8,620,769 8,713,367 8,834,236 9,095,569 9,082,458
Revenues over (under) expenditures (3,178,584) (3,934,099) (3,018,783) (2,414,553) (3,559,956)
Other financing sources (uses)
Transfers from other funds 3,178,586 3,559,851 3,018,782 2,837,174 3,379,710
Transfers to other funds - - - - -
Total other financing sources (uses) 3,178,586 3,559,851 3,018,782 2,837,174 3,379,710
Net change in fund balance 2 (374,248) (1) 422,621 (180,246)
Fund balance, beginning of year 952,574 952,576 578,328 578,327 1,000,948
Fund balance, end of year 952,576$ 578,328$ 578,327$ 1,000,948$ 820,702$
FTE (Employees)
Health 85.35 85.65 87.23 86.65 88.55
Unfunded positions 2.6 1.6 1.6 1.6 1.6
Financial Statement
SOURCES
Page 5
[1]
“Reported Incidence of Communicable Diseases in the United States, 1949.” Public Health Reports (1896-1970),
vol. 65, no. 19, 1950, pp. 632–643. www.jstor.org/stable/4587336.
[2]
March of Dimes, A history of the March of Dimes: The polio years, https://www.cdc.gov/measles/about/history.html
[3]
Centers for Disease Control and Prevention, Measles History, https://www.cdc.gov/measles/about/history.html
[4]
Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR) February 20, 2015 / 6 4(06);153-154 Measles Outbreak:
California, December 2014–February 2015, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_ w
[5]
Michigan Department of Health and Human Services: County Immunization Report Card, Data as of December 31, 2016,
http://www.michigan.gov/mdhhs/0,5885,7-339-73971_4911_4914_68361-321114--,00.html
Page 7 Medically Complex and the Stories of Our Lives: Rhyse’s story, http://medicallycomplexfamilies.blogspot.com/
Page 21
[6]
Centers for Disease Control and Prevention, Healthy Water, https://www.cdc.gov/healthywater
Page 22
[7]
Centers for Disease Control and Prevention, About Zika Virus, https://www.cdc.gov/zika/
Page 22
[8]
Ottawa County Department of Public Health Monthly Reportable Diseases, http://www.miottawa.org/Health/OCHD/pdf/data/2016_Monthly_CD.pdf
Page 23
[9]
Cost of Zika - Kaiser Family Foundation, The Zika Virus: What’s Next in the U.S. and Abroad, 2/17/2016,
http://files.kf f.org/attachment/transcript-february-17-web-briefing-for-media-the-zika-virus-whats-next-in-the-u-s-and-abroad
Page 25
[10]
Centers for Disease Control and Prevention, Oral Health Basics, https://www.cdc.gov/oralhealth/basics/index.html
[11]
2015 Ottawa County Health Needs Assessment (pages 178, 167), http://www.miottawa.org/Health/OCHD/pdf/OCCHNA_Full_Report.pdf
[12]
2014 Ottawa County Behavioral Risk Factor Survey (page 112), http://www.miottawa.org/Health/OCHD/pdf/OCBRFSReport.pdf
Page 27
[13]
United States Environmental Protection Agency, Learn about lead, https://www.epa.gov/lead
[14]
Centers for Disease Control and Prevention, Blood Lead Levels in Children, https://www.cdc.gov/nceh/lead/ACCLPP/Lead_Levels_in_Children_Fact_Sheet.pdf
Page 28
[15]
U.S. Environmental Protection Agency, Percentage of homes likely to contain lead-based paint, https://www.epa.gov/lead/protect-your-family-exposures-lead#sl-home
[16]
Michigan Department of Health and Human Services: Medicaid Blood Lead Testing, July 2016, http://www.michigan.gov/documents/mdhhs/JULY_2016_WEB_
RPT_530605_7.pdf, Accessed from http://www.michigan.gov/mdhhs/0,5885,7-339-73970_2944_5327-102097--,00.html
[17]
Michigan Department of Health and Human Services: 2015 Provisional Data Report on Childhood Lead Testing and Elevated Levels: Michigan,
http://www.michigan.gov/documents/lead/Provisional_2015_Lead_report_526117_7.pdf,
Accessed from http://www.michigan.gov/lead/0,5417,7-310-66221_66223---,00.html
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Childhood Lead Exposure and Prevention in the City of Holland (49423): Holland Lead Technical Committee; May 12, 2016;
http://www.cityofholland.com/sites/default/files/fileattachments/childhood_lead_exposure_and_prevention_in_teh_city_of_holland_49423.pdf
IMAGE AND VIDEO SOURCES
Cover Heather Cole
Pages 4, 6, 7 Immunize - Heather Cole
Page 8 Children's Special Health Care Services - Lisa Huisman Photography
Page 10 Food Services - www.GraphicStock.com, (burger-9-24.jpg)
Pages 12-15 Hearing and Vision - Ottawa County Department of Public Health, by Kristina Wieghmink
Page 16 Maternal & Infant Health Program - www.GraphicStock.com, (JM-03292016-Healthy-800_4858.jpg)
Pages 18-21 BeachWatch - Ottawa County Department of Public Health, by Kayla Anderson
Page 23 Zika - WZZM13, September 14, 2016, 9 people confirmed to have Zika in Ottawa County,
http://www.wzzm13.com/news/health/9-people-confirmed-to-have-zika-in-ottawa-county/318775051
Page 24 Dental - www.GraphicStock.com, (cbi-0216-050_031_090612.jpg)
Page 25 Dental - wotv4women, "Free dental care on the move" By Maranda, 05/10/16; http://wotv4women.com/2016/05/10/free-dental-care-on-the-move/
Page 26 Corey Coyle via Wikimedia Commons, https://upload.wikimedia.org/wikipedia/commons/c/cf/George_O._Gordon_House_-_panoramio_-_Corey_Coyle.jpg
Page 27 Lead - Child at window sill, iStockphoto, Glenn Bo (071203204513)
Page 28 Lead - Ottawa County Department of Public Health, by Jessica Voglewede (paint cans); Solder: https://commons.wikimedia.org/w/index.php?curid=1176933;
Gas pump: http://ens-newswire.com/wp-content/uploads/2011/11/20111111_oldgaspump.jpg; Lead pipe/faucet: http://www.leadsafeillinois.org/
uploads/images/faucet.jpg; Toy soldier: https://commons.wikimedia.org/w/index.php?curid=7259635; Stained glass: https://commons.wikimedia.org/w/index.
php?curid=47005130; Blue paint: https://commons.wikimedia.org/w/index.php?curid=31842565; Lead jewelry: http://californiawatch.org/dailyreport/lead-
tainted-jewelry-item-found-f lea-market-5888; Pottery: https://upload.wikimedia.org/wikipedia/commons/c/c6/Mexican_pottery_at_Anita%27s_in_
Bothell%2C_WA_05.jpg
Page 29 Lead - Child sitting on window sill, www.GraphicStock.com (DM_03242016_1422.jpg)
Page 30 Shannon Felgner; M23.1k Run & Relay video, https://www.youtube.com/watch?v=5IXeHWLRJXg&feature=youtu.be
Page 31 ecoOttawa - Ottawa County Parks & Recreation, Hemlock Crossing in West Olive, MI
Page 33 Ottawa County Food Policy Council
Pages 35-37 Ottawa County Parks & Recreation photos; Ottawa and Allegan County Featured Trail guides http://www.miottawa.org/Health/OCHD/nutrition.htm;
WHTC, 09/21/2016, Ottawa Co. Parks Update with Jessica VanGinhoven, http://whtc.com/podcasts/talk-of-the-town-today/99/ottawa-co-parks-update-with-
jessica-vanginhoven-sept-21/; Ottawa and Allegan County Fresh Food guides http://www.miottawa.org/Health/OCHD/nutrition.htm#farmers
Pages 38-39 Sexual Health - www.GraphicStock.com (https://www.graphicstock.com/stock-image/group-of-six-friends-having-fun-outside-htvy7saboiskjerwp)
Page 40 Ottawa County Youth Assessment Survey - Corbis Images (42-57623497)
Pages 42-43 Substance Abuse Prevention Program, www.GraphicStock.com, (DM_03242016_0953)
Pages 44-45 Emergency Preparedness - Ottawa County Department of Public Health, by Kristina Wieghmink

Holland
12251 James St
Clinic Services
(616) 396-5266
Environmental Health
(616) 393-5645
Grand Haven
1207 South Beechtree St
Suite B, (616) 846-8360
Hudsonville
3100 Port Sheldon Ave
(616) 669-0040
www.miOttawa.org/miHealth
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