Sidney-Shelby County

Board of Health

2018 ANNUAL REPORT2018 ANNUAL REPORT2018 ANNUAL REPORT

202 W. Poplar Street Sidney, Ohio 45365 E-mail: sschd@shelbycountyhealthdept.org

Phone: 937-498-7249 Fax: 937-498-7013

Website: shelbycountyhealthdept.org

HEALTH DEPARTMENT STAFF

Health Commissioner Environmental Nursing Division Steven J. Tostrick, MPH, REHS, RS Kent Topp, RS — Director Erica Lentz, BSN, RN — Director Julie Geise, RN

Mike McClain, RS Kathy Cavinder, BSN, RN Teri Greve, RN

Clerical Roberta Mangen, MPH, RS Audrey Chisholm, RN Kara Kaczmarek, RN

Jenni St. Myers — Adm. Asst./Registrar Rusty Schwepe, RS Alicia Cooper, RN Jannel O’Leary, RN

Jane Adams Jay Stammen, RS Linda Daniel, BSN, RN Jenny Poppe, BSN, RN

Kim DeLoye Ted Wuebker, RS

Kathy Hines

Mary Hormann

Medical Director HMG—Home Visiting WIC

Paul W. Weber, MD Laura Booth Tia Toner — Project Director

Carol Dircksen, DTR

Contracted Services Kamille Lambert

Epidemiological Services — Preble County Health District Shannon Nagel, RN

Plumbing Program — Miami County Public Health

WIC Nutrition Services — Wilson Memorial Hospital

2018 SIDNEY-SHELBY COUNTY

BOARD OF HEALTH FUNDS

2018 Board of Health Members

Left to Right: Matthew Vasko, MD, Aaron Sargeant, DVM,

PhD, (Vice-President), James Hemmelgarn, (President),

Ted Holthaus, MBA, PAS and Bill Gosciewski, PE retired.

2018 Annual Report, Page 2

Paul Weber, MD

Medical Director

Accreditation

The 2012 Legislative Committee on Public Health Futures report recommended that all local health districts shall meet Public Health Accredita-

tion Board (PHAB) eligibility within five years. Recognizing the benefits of PHAB accreditation, the 130th General Assembly in 2013 codified

the authority for the Director of Health to require all local health districts to apply for accreditation by 2018 and to become accredited by 2020.

Requiring Ohio's local health districts to become accredited by PHAB will demonstrate that they are meeting or exceeding a common set of na-

tional standards; have the capacity to provide core public health services; and are continually striving to improve service, value, and accountabil-

ity to stakeholders.

Ohio Revised Code Sec. 3701.13: As a condition precedent to receiving funding from the department of health, the director of health may re-

quire general or city health districts to apply for accreditation by July 1, 2018, and be accredited by July 1, 2020 by an accreditation body ap-

proved by the director. The director of health, by July 1, 2016, shall conduct an evaluation of general and city health district preparation for ac-

creditation, including an evaluation of each district's reported public health quality indicators as provided in section 3701.98 of the Revised Code.

Our department applied for accreditation in 2018 and continues to work toward the accreditation requirements as set by the above actions. The

annual report helps to provide support data for the Community Health Assessment, Community Health Improvement Plan, Strategic Plan, Work-

force Development Plan, and Performance Management & Quality Improvement Plan.

Steven J. Tostrick,

MPH, REHS, RS

Health Commissioner

FUNDS REVENUE EXPENSES BALANCE

HEALTH $1,640,787.95 $1,198,131.71 $442,656.24

CAMPS 9,407.22 6,340.53 3,066.69

SOLID WASTE 15,485.68 9,341.19 6,144.49

POOLS 12,069.97 10,506.53 1,563.44

FOOD SERVICE 117,805.78 108,593.52 9,212.26

WATER 37,811.97 32,939.90 4,872.07

PLUMBING 134,677.84 83,730.90 50,946.94

IAP 57,573.08 57,573.08 0.00

SEWAGE 105,053.76 71,002.07 34,051.69

PHEP 75,562.70 75,562.70 0.00

HMG-HOME VISITING 115,481.90 55,135.54 60,346.36

WOMEN, INFANTS &

CHILDREN PROGRAM 233,956.27 232,212.85 1,743.42

TOTALS $2,555,674.12 $1,941,070.52 $614,603.60

2018 Annual Report, Page 3

Public Health Nursing

Left to Right: Audrey Chisholm, RN,

Jannel O’Leary RN, Teri Greve, RN,

Erica Lentz, BSN, RN (Director of

Nursing), Linda Daniel, BSN, RN,

Alicia Cooper, RN, Kathy Cavinder,

BSN, RN, Julie Geise, RN, and Jenny

Poppe, BSN, RN

Not Pictured: Kara Kaczmarek, RN.

School Health

The schools of Shelby County (City, County & Parochial) contract

with the Sidney-Shelby County Health Department for public health

nurses to provide school health nursing services. Services include:

communicable disease checks and follow up, vision screening and

referral, multi-factored evaluation screenings, involvement on school

wellness teams, student and staff health fairs, health education

classes (dental care, hand washing, hygiene, puberty, growth and

development, abstinence) and in-service trainings for staff.

Daily clinics are provided at Anna, Ft. Loramie, and Houston

schools. Daily visits are completed for multi-handicap students pro-

viding g-tube feedings, medications, suctioning, catheterizations and

carb counting for diabetics.

The Give Kids A Smile Day event was held at Compassionate Care

facility to screen students for dental issues. They are then followed

by local dentists for six months.

Immunizations The Sidney-Shelby County Health Department Immunization Pro-

gram provides services to prevent and protect the public against vac-

cine preventable diseases.

A public health nurse provided MOBI (Maximizing Office Based

Immunization) education to 2 physicians and their office staff. The

AFIX (Assessment, Feedback, Incentives and Exchange) Immuniza-

tion Program was completed for 5 providers including the Sidney-

Shelby County Health Department. The Sidney-Shelby County

Health Department continues to provide VFC (Vaccine for Children)

from the Ohio Department of Health.

The Sidney-Shelby County Health Department accepts most insur-

ance companies through VaxCare.

International travel consultation and vaccinations are available by

appointment.

A nurse is available from 8:30 AM to 11:00 AM and from 12:30 PM

to 2:30 PM Monday through Friday. Immunizations are available by

appointment.

Immunizations Given: Number

Childhood Immunizations 2,091

Adult Immunizations 948

Flu Vaccine 426

International Travel/Adult 112

Communicable Disease Control

The Sidney-Shelby County Health Department reports, investigates,

and provides follow up on Shelby County’s reportable infectious dis-

eases. Treatment resources and prevention practices are discussed

through consultation and education. Cooperation in disease reporting is

invaluable to public health. Disease reporting aids state and local offi-

cials in surveillance and prevention of outbreaks and possible bioterror-

ism events.

Number

Communicable Diseases Reported & Investigated 371

Total Mantoux TB Tests Administered & Read 182

2018 Top 5 Reportable Communicable Diseases

Shelby County

Chlamydia 165 A sexually transmitted disease (STD)

Influenza 69 A contagious respiratory illness, caused by a

virus

Gonorrhea 39 A STD (often occurs along with

Chlamydia)

Hepatitis C 32 This virus infects the liver and becomes a

chronic illness

Campylobacter 13 A bacterial infection of the G.I. tract

Well Child Clinic

Assessments and screenings are performed on clients birth to age 21,

with an emphasis on health promotion and preventative health prac-

tices. The clinic is for those on Medicaid. If uninsured, payment on

day of service is required using a sliding fee scale.

Number

Clients 32

Medicaid 91%

Uninsured/No Insurance 9%

Newborn Home Visit Program

Emerson Climate Technologies assists with funding the newborn home

visit program to assure there is a safe sleep environment for the new-

born. Our public health nurse visits the mother and child assessing the

mother, child and environment. The visit is voluntary and free. The

visit is prioritized with first time mothers, teen mothers, single mothers

and breastfeeding mothers. Referrals are received from the Wilson

Memorial Hospital Obstetrics Department.

Number

Home Visits 55

Hospital Visits 176

Referrals Received 318

Public health nurses provide services

throughout Shelby County to ap-

praise, protect and promote the health

and well-being of our residents. This

is accomplished through direct patient

care services, population-based ser-

vices, education, and health promo-

tion activities.

Women, Infants & Children (WIC)

The Sidney-Shelby County Health Department has had the WIC

(Women, Infants and Children) Grant since October 2006. WIC is a

supplemental nutrition education program. WIC provides nutritious

foods and promotes good health for pregnant women, women who just

had a baby, breastfeeding mothers, infants, and children up to age five.

The Sidney-Shelby County Health Department has an average monthly

participant rate of 699.

WIC provides nutrition education and support, breastfeeding and sup-

port, referral for health care, immunizations screening and referral, and

supplemental foods. Wilson Memorial Hospital dietitian also provides

nutritional counseling to high-risk clients in the WIC Clinic.

Emphasis on breastfeeding is being accomplished with a peer helper

and IBCLC certified breastfeeding nurse. Any Shelby County breast-

feeding mother can receive support and education to help give babies a

healthier start to life.

Public Health Emergency Preparedness

A public health emergency (manmade or natural) is any event or situa-

tion demanding immediate action on the part of the public health sys-

tem to prevent disease or injury and maintain health within the commu-

nity of service.

The Sidney-Shelby County Health Department receives grant funding

for Public Health Emergency Preparedness (PHEP). The goal is to

address bioterrorism, other outbreaks of infectious disease and other

public health threats and emergencies at the county and regional health

level. In recent years, there has been an emphasis on planning for ra-

diological events and coordinating emergency plans between all health-

care providers within Shelby County.

Please visit the Sidney-Shelby County Health Department’s website at

www.shelbycountyhealthdept.org. The website allows us to distribute

time sensitive information quickly during a public health emergency.

The website is also user friendly for our day-to-day needs.

All Shelby County residents should be prepared for all types of public

health emergencies. This means being able to sustain yourself and your

family for 72 hours before help may arrive. Visit www.ready.gov to

make plans and prepare your family for the next local emergency.

2018 Annual Report, Page 4

Laura Booth

(HMG Home Visitor)

Bureau for Children With Medical Handicaps

(BCMH)

A public health nurse assisted Shelby County families in accessing

and obtaining the most appropriate health care and related services for

children with special health care needs. Contact is made through a

home visit, office visit, email or by phone. Shelby County families

from all social economic backgrounds who have a child with special

health care needs are eligible for BCMH (even if they have insurance).

Number

BCMH Home/Office Visits (unduplicated contact) 269

Total Children on BCMH 374

Health Promotion

The Sidney-Shelby County Health Department has three certified car

seat technicians who provide car seat inspections by appointment.

The car seat technician instructs the parent on proper installation of

the new car seat.

Honda of America provided funds to the Health Department for a car

seat check event.

Number

Car Seats Distributed With Parents Instructed 73

Car Seat Inspections 79 Bicycle helmets are available free (while supplies last) at the Sidney-

Shelby County Health Department and are fitted by a public health

nurse. A helmet grant assisted the Health Department in providing

participants of the Safety Town event a new helmet. Number

Bike Helmets Distributed (Free while supplies last) 87

The nursing staff provides community based health promotion activi-

ties at health fairs providing Dermascan, cholesterol, glucose and

blood pressure screenings and body mass index. The Sidney-Shelby

County Health Department had a booth at the Shelby County Fair. Number

Total Health Fairs 1

Help Me Grow—Home Visiting

The HMG Home Visiting Program remains at the Sidney-Shelby

County Health Department. A home visitor provides first time expec-

tant or new parents the information and support they need to be pre-

pared for the birth of their child. Also, ongoing education and support

for families to maximize their child’s health and development up to

age 3 is provided. The program has four goals: increase healthy preg-

nancies, improve parenting confidence and competence, improve child

health development and readiness and increase family connectedness

to community and social support. Number

Caseload 26

Home Visits 347

Left to Right: Shannon Nagel, RN (Breastfeeding Consultant),

Kamille Lambert (Breastfeeding Peer), Tia Toner (Project Director)

and Carol Dircksen (Registered Dietetic Technician).

Environmental Health The Environmental Health division had another busy year protecting

public health in Shelby County with the various environmental pro-

grams. The potential of food-borne illness was reduced by inspections

made of licensed facilities that sell food. Water supplies were protected

by inspections made on household sewage treatment and private water

systems. Some of the other programs such as campground, manufac-

tured home park, public swimming pools/spas, school and plumbing

programs helped to ensure the well-being of county residents. Many

nuisance and solid waste problems were abated. Time was dedicated to

disaster planning and disease control activities. Public places and places

of employment were investigated to ensure compliance with the Smoke

Free Workplace Law. Radon awareness information and test kit coupons

are provided to the public. Anyone having questions for the environ-

mental division is encouraged to call.

Sewage Treatment Systems

All land surveys of lots less than five acres in size and surveys that

reduce acreage from a lot with an existing sewage system are reviewed

to ensure they meet minimum standards of residential lots. New and

existing household sewage treatment systems are inspected to ensure

the systems conform to existing installation and operational standards.

Septage hauler trucks are inspected and septage disposal is monitored

to prevent nuisance conditions and disease.

Number/Permit Inspections Consultations

Subdivision Survey/Lots 25 27 85

Household Sewage Disposal 40 76 152

Aeration/Operational Permits 911 958 265

Aeration Service Contractors Registered 4 4 5

Sewage System Installers Registered 17 17 157

Septage Haulers 8 2 37

Housing/Nuisance Conditions, Rabies Control

Dwellings with suspected problems are inspected for sanitation, fire

and safety hazards. Homes must be brought to minimum standards for

health and safety reasons. The Sidney-Shelby County Health Depart-

ment is responsive to any nuisance complaint or request to investigate

an environmental condition that may threaten public health. This can

include insect and/or rodent control. All animal bite incidents are in-

vestigated to ensure the control of rabies. Number Inspections Consultations

Nuisance/Housing Complaints 87 80 377

Animal Bites Reported

Dogs/Cats 67/15

Other (Wild) 0

Animals Tested for Rabies 6

Animals Testing Positive 0

Food Programs

All licensable facilities that sell food as meals or as groceries are li-

censed and inspected to help protect the public from foodborne dis-

eases. Temporary and mobile food service operations are also in-

spected at many festivals and events.

Licensed Inspections Consultations

Food Service/Retail Food Establishments 244 527 344

Vending Locations 71 61 15

Temporary Food 77 78 56

Mobile Food 9 9 103

Facility Reviews 20

Camps and Manufactured Home Parks

All public campgrounds and manufactured home parks (MHP) are li-

censed and inspected for sanitation and maintenance to minimize public

health nuisance conditions. The MHP Program licensing transferred to

the Ohio Department of Commerce (DOC) and the Sidney-Shelby

County Health Department contracted with them to do the MHP inspec-

tions. The Ohio Department of Commerce took over the MHP program

in 2018 from the OMHC.

Licensed Inspections Consultations

Manufactured Home Parks 11 12 9 RV Park Camps 7 13 19

Temporary Camps 10 11 17

Resident Day Camp 1 1 5

Private Water Systems

Permits are issued to install or alter water wells throughout the county.

These wells are inspected and water samples are taken to ensure a safe

drinking water supply. Abandoned wells are sealed to protect the

ground water supply.

Number Inspections Consultations

New Well Permits 56 75 328

Alteration Permits 3 3 13

Water Samples Tested 149 61 381

Sealing Permits 11 11 34

Body Art/Tattoo and Body Piercing

The Sidney-Shelby County Health Department approves tattoo and

body piercing establishments. Inspections include equipment, site,

sterilization equipment and methods and required paperwork.

Facilities Inspections Consultations

Establishments 5 5 11

Schools and Correctional Facilities

Schools and correctional facilities are inspected to ensure they are

meeting minimum health and safety standards to help promote good

housekeeping, accident prevention and maintenance of properties.

Facilities Inspections Consultations

Schools and Correctional Facilities 25 29 32

2018 Annual Report, Page 5

Standing: Mike McClain, RS, Roberta Mangen, MPH, RS, Rusty

Schwepe, RS, and Jay Stammen, RS.

Seated: Kent Topp, RS (Director of Environmental Health) and

Ted Wuebker, RS.

Plumbing Program

Responsible for registering plumbing contractors, issuing permits,

inspecting new and altered plumbing systems and educating plumbers

on state code requirements. Number

Plumbing Contractors Registered 88

Residential/Commercial Permits Issued 183

Solid Waste Disposal

The transportation, storage and disposal of all garbage, refuse, and

infectious waste are monitored to prevent nuisance conditions. Spe-

cial solid waste clean-up projects are conducted to assist townships

and villages. Almost 16 tons of solid waste was collected and prop-

erly disposed of as part of two clean-up sites organized by the Sidney-

Shelby County Health Department in collaboration with the Township

Trustees. Class IV compost facilities, the transfer station and the

closed landfill were also inspected.

Registered Inspections Consultations

Solid & Infectious Waste Facilities 14 14 49

Class IV Compost Facilities 3 3 15

Clerical Suppor t - Vital Statistics Birth and death records are kept on file dating back to December 1908. Vital

Statistics offices in Ohio utilize a uniform security paper for issuance of birth

and death certificates. The Sidney-Shelby County Health Department utilizes

the statewide birth record database maintained by the Ohio Department of

Health. With statewide access, individuals may obtain certified copies of an

Ohio birth record from their local health department regardless of the county

where the birth occurred. Certified birth certificates are issued for many legal

purposes from obtaining social security numbers to driver’s licenses. Death

certificates are needed for insurance claims and to change social security

benefits after death. Birth and death records can assist in genealogy research.

Statistical examination for epidemiological purposes can also be done, assist-

ing in community assessment activities. Birth and death certificates can be

obtained in person, by mail, or by phone with credit card payment.

Standing: Kim DeLoye (Account Clerk), Jane Adams

(Clerical Specialist), and Mary Hormann (Clerical

Specialist/Deputy Registrar).

Seated: Kathy Hines (Clerical Specialist), and Jenni

St. Myers (Administrative Assistant/Registrar).

2018 Annual Report, Page 6

Swimming Pools and Spas

Public swimming pools and spas are licensed and inspected to ensure

these facilities are properly set up and maintained. Proper water chemis-

try and safety equipment must be available.

Licensed Inspections Consultations

Public Swimming Pools, Spas, 22 54 39

Wading Pools and Spray Grounds

Smoke Free Workplace

Chapter 3794 of the Ohio Revised Code (ORC) prohibits all forms of

tobacco smoke in all public places, places of employment, and in areas

immediately adjacent to the ingress or egress of the public place or place

of employment. Smoking complaints are investigated to ensure compli-

ance with the Smoke Free Workplace Law. Number Investigations Consultations

Smoking Complaints 1 1 4

Warnings Issued 0

Fines 0

Dismissed Investigations 1

Hours Spent In Program 64

Births Number

Births Recorded in Shelby County 715 Hospital 707

Out of Institution 8

Males 359 Females 356

Sets of Twins 7

Oldest Mother 41 Youngest Mother 15

Birth Certificates Issued 2,635

Deaths Number

Deaths Recorded in Shelby County 348 Males 181

Females 167

Oldest 102 Youngest 53 Minutes

Death Certificates Issued 1,256

Burial Permits Issued 452

Causes of Death Number

Accident—Motor Vehicle 7

Accident—Other 13

(9 Drug/Alcohol, 1 Falls, 1 Asphyxia, and 2 Drowning)

Advanced Age 2

Alzheimer’s/Dementia 19

Causes of Death Cont’d. Number Cancer - Top 2 cancer deaths 73 Lung, Colon

Cardiovascular 130

Cerebrovascular 15 Dehydration 12

Diabetes Mellitus 2

Gastrointestinal 2 Influenza 1

Liver Disease/Cirrhosis 5

Metabolic 1 Other 3

Parkinson’s Disease 2

Pending/Investigation 1 Pneumonia 9

Renal Failure 12

Respiratory/COPD 25 Sepsis 6

Suicide/Homicide 8/0

Statistical Information