2015 - Wicomico County Health Department

ANNUAL REPORT
FISCAL YEAR 2015
Lori Brewster, M.S., APRN/BC, LCADC
Wicomico Health Officer
Publication date: September 1, 2015
The health department is making strides to address many of
the public health needs in our community.
Our Community Health Assessment (CHA) Survey, which is
done every five years, assisted the Local Health Improvement
Coalition to determine our direction for 2015 to 2020. Areas
identified as our target over the next 5 years include: Access to
Care, Behavioral Health, Chronic Disease (Diabetes, Obesity,
Nutrition and Physical Activity), Oral Health Care for Adults, and
Tobacco. Subcommittees of the Coalition continue to work diligently to
address the identified community needs. Members of the community that
would like to complete the next CHA, may do so at www.wicomicohealth.org.
Health Department programs and services continue to impact many of the
areas identified in the Community Health Assessment Survey as well as other
areas of need. Committed Health Department employees are working very
hard every day to move the needle on the public health issues effecting our
community.
This document presents data and initiatives to address many of these issues.
Lori Brewster
Wicomico Health Officer
I would like to recognize and thank the employees of the
Wicomico County Health Department for the work they
provide to the public on a daily basis.
The services and information they provide to County residents
are incredibly important for community health and awareness.
The public is encouraged to research services that the Health
Department may provide that they may be unaware of – such as their
Women, Infants, and Children's program, Environmental Health services, and
assistance to citizens who may not otherwise have health care provided to
them.
The Wicomico County Health Department deserves to be commended for
their diligent work for the well-being of our beautiful County.
Bob Culver
Wicomico County Executive
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
ACCESS TO CARE
According to the 2014 Community Health Needs Assessment, opportunities
for improvement exist with regard to individuals having a specific source for
ongoing health care in the community.
Improving health care services depends in part on ensuring people have a
usual and ongoing source of care. Better health outcomes and fewer disparities and costs are achieved when people have a routine source of care.
While 79.7% of people in Wicomico County have a particular place identified
for medical care, only 69.9% of people identified have a specific source of
ongoing medical care. Healthy People 2020 target is 95% or higher.
A sub-committee of the LHIC is organizing to explore the causes for this issue
and to develop a plan to address opportunities for improvement.
Language interpretation services are provided to Limited English Proficient
(LEP) clients at no cost to them, through bi-lingual staff, medically certified
contract interpreters and telephonic language services.
Number of LEP clients served:
Cost to provide LEP service:
2,781
$23,778.98
ORAL HEALTH CARE FOR ADULTS
The 2014 CHNA survey showed that only 60.4% of adults in Wicomico had
seen a dental provider in the last year, compared to 72.7% statewide.
In FY 2015, an Adult Dental Safety Net Task Force was established and
tasked with developing strategies to improve this health care challenge.
Plans for FY16 include developing an administrative structure to apply for
and manage grant funds and screen indigent clients with dental needs, and
to develop a network of providers willing to provide dental services at
reduced fees. The Task Force will also collaborate with other stakeholders
and groups working around the state on adult dental care access.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
BEHAVIORAL HEALTH
The Methadone Maintenance Program was re-accredited by the Joint
Commission in March 2015 and continues to expand in response to the
opioid use epidemic.
Joint Commission accreditation challenges providers to think
creatively and to focus on performance improvement.
Accreditation also strengthens community confidence, quality
and safety of care, treatment and services.
In FY 2015, Wicomico Behavioral Health and Community Health Services
programs developed a partnership to provide bi-directional mental health,
substance abuse and family planning referrals and services to women of child
bearing age. This program, known as the Family Planning: Wicomico
Mental Health and Substance Abuse Treatment Collaboration, has increased access to care for uninsured as well as LEP clients.
The Family Planning: Wicomico Mental Health and Substance Abuse
Treatment Collaboration has been successful in preventing unnecessary
emergency petitions and emergency room visits.
Crisis Intervention Team (CIT) training is designed to train first responders
to support people in a behavioral health crisis.
In FY 2015, 54 police and correctional officers from Wicomico and Somerset counties completed the 40 hour CIT training course.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
ADDRESSING PRESCRIPTION DRUG ABUSE
In calendar year 2014, 20 individuals died of a drug overdose in Wicomico
County. Wicomico’s Overdose Fatality Review Team reviews each overdose
case and provides information to create prevention strategies to further prevent deaths due to overdose.
In FY 2015, 162 individuals were certified to administer Naloxone®, including 50 members of the community and 112 law enforcement officers from
Fruitland City Police. Salisbury City Police, Wicomico County Sheriff's Office,
and Delmar City Police.
Drug Free Wicomico and the Prescription Drug Task Force includes over
40 members, who have been involved in developing a comprehensive Opiate
Media Campaign with a.s.a.p.r. Integrated Marketing that will run through
September 2015.
The Wicomico County Drug Action Response Team (DART) is a group of
drug free youth from local high schools who
have been meeting for over two years. Their
mission is to provide information to children,
youth and adults on legal and illegal drugs.
In FY 2015, DART members developed a script
and a song for social media to educate peers
on drug use.
In FY 2015, 599 pounds of prescription and over the
counter medications were collected at drop boxes at the
Wicomico County Sheriff’s Department, City of Salisbury,
Delmar, and Fruitland Police Departments.
In FY 2016, new drop boxes will be added at the Maryland
State Police Salisbury Barracks and Apple Discount Drugs in
Fruitland to increase access.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
CHRONIC DISEASE
With the release of the 2014 Community Health Needs Assessment, the LHIC
elected to merge diabetes and obesity under the Chronic Disease umbrella
since the strategies to improve both conditions are much the same. This
group now serves as the Live Healthy Wicomico Task Force.
According to the 2014 CHNA, the prevalence of obesity in Wicomico County is
37.3% and diabetes prevalence is 16.5%. Strategies for improvement will
be focused on the following:
 Promoting a shared culture of healthy living through community
engagement by increasing access to healthy foods and enhancing the
built environment to support active living.
 Establishing formal referral systems linking at risk patients to follow-up
health care.
 Improving identification of undiagnosed persons with pre-diabetes in
clinical settings.
Activities that improve diabetes and obesity in the community will also have
an impact on other chronic diseases such as hypertension, heart disease,
stroke, cancer and behavioral health problems.
DIABETES
2014 County Health
Rankings data shows
the rate of diabetic
screening is 84%
in Wicomico County.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
TOBACCO
Although the trend for cigarette smoking is going down as reported by
Network of Care, Healthy People 2020 goals have yet to be reached:
The Cigarette Restitution Fund (CRF) Tobacco Program awarded two
community agencies $4,500 each to provide tobacco education to the community. Awardees Jireh Community Development, Inc. and St. Paul Community Empowerment Center, Inc. focused on educating youth and adults on the
dangers of e-cigarettes. Health fairs, educational classes and a community
fun day event were conducted.
The CRF Tobacco program partnered with the
Maryland Behavioral Health Administration to host
the 15th Annual Underage Substance Use
Reduction Luncheon, recognizing enforcement
officers, local establishments and community
members for their hard work and dedication to
reducing substance use in Wicomico County.
Due to the high rate of pregnant women that smoke in Wicomico County,
three community agencies were granted $3,800 each through the Center for
Tobacco Prevention and Control PATCH (Pregnancy and Tobacco Cessation
Help) initiative. Destiny Family, Inc., Empowered Women Ministries, Inc., and
Wicomico Family Support Center used the funds to educate pregnant women,
women of child-bearing age and their households on the dangers of tobacco
use and second-hand smoke. Educational classes, health and wellness
workshops, staff trainings and community health fairs were used to bring
awareness and education to the community.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
SEXUALLY TRANSMITTED INFECTIONS
The Wicomico STI Task Force has received statewide recognition for its success, and as an innovative community collaboration.
Since the Task Force began in 2013, Wicomico County has seen a 19.4% reduction in Chlamydia rates, and an 11.5% reduction in Gonorrhea rates,
while rates statewide continued to increase.
In 2014, Wicomico
had a Chlamydia
incidence rate
of 566.3 per
100,000 population
compared to a
2013 incidence
rate of 640.2 per
100,000 population.
In 2014, Wicomico
had a Gonorrhea
incidence rate
of 185.2 per
100,000 population
compared to a 2013
rate of 193.3 per
100,000 population.
Network of Care, 2015
DHMH Center for
STI Infection, 2013
Chlamydia in Wicomico County, 2005 - 2014
(Cases/100,000 population)
Wicomico
Maryland
US
MD Counties
Gonorrhea in Wicomico County, 2005-2014
(Cases/100,000 population)
Wicomico
Maryland
US
MD Counties
Maryland Dept. of Health and Mental Hygiene, 2014
* Note: US 2013 rates (US 2014 rates not yet available.)
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
PROGRAM ACCOMPLISHMENTS
Environmental Health staff coordinated 4 rabies clinics
throughout Wicomico County, allowing 484 dogs and cats to be
vaccinated against rabies.
61 septic systems were upgraded, preventing over 700 pounds of nitrogen
from entering our ground and surface waters.
In April 2015, the Resource Coordination program transitioned to the
Coordination of Community Services Program. Program staff continues to
coordinate information and referral services to developmentally disabled
adults, children, and their families.
In FY 2015, program staff reached out to the community through several
resource fairs and were instrumental in promoting the Mission of Mercy,
an all volunteer mission providing free adult dental services.
PRP New Clients Admitted
FY
2014
FY
2015
The Psychiatric Rehabilitation Program (PRP)
has seen an increase in the number of children
and adults referred and enrolled into the program.
With this increase in caseload, two new staff
members have been hired, increasing program
staff size from three to five full time employees.
In FY15, health department staff attended 31 health fairs to promote public
health initiatives and increase awareness of programs and services.
@WicomicoHealth continues to maintain active social media accounts, with
1,785 Facebook® and 596 Twitter® followers. Instagram®, Pinterest®, and
YouTube® pages continue to increase in number of followers.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
WICOMICO HEALTH IN THE COMMUNITY
Wicomico Health staff work tirelessly to meet the public health needs of
the community through regular clinics, vaccination clinics, car seat checks,
health fairs, and other events.
In observation of National Public Health Week, an individual is awarded
the Outstanding Public Health Leader Award for Wicomico County. In
April 2015, Celeste Savage (top left in the photo below) was recognized
for her efforts to help the most vulnerable in our community.
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org
LOCAL HEALTH IMPROVEMENT COALITION
Wicomico’s Local Health Improvement Coalition reviewed the newly released 2014
Community Health Needs Assessment (CHNA).
A CHNA provides information so that communities may identify issues of greatest
concern and decide to commit resources to
those areas in order to make the greatest
possible impact on community health
status. A CHNA serves as a tool to assist
communities to reach 3 basic goals:
 To improve residents’ health status,
increase their life spans, and elevate
their overall quality of life.
 To reduce the health inequalities among residents.
 To increase accessibility to preventive service for all community residents.
The entire CHNA document may be viewed at www.wicomicohealth.org.
Priority focus areas for 2015-2017 identified by the LHIC are Behavioral Health,
Access to Care, Chronic Diseases (Diabetes, Obesity, Nutrition and Physical Activity), Tobacco Use Prevention, and Oral Healthcare for Adults.
LHIC sub-committees for each focus area have been established and charged with
developing and implementing strategies to improve each priority through collaboration and partnership.
Community members are welcomed and encouraged to participate with the LHIC
on any of the sub-committees to assist with collaborative efforts to improve the
health of Wicomico County.
Adventist Health Care
Hope, Inc.
City of Salisbury
K & L Microwave
Coastal Hospice
MAC, Incorporated
Community Empowerment Center Peninsula Regional Medical Center
Community Foundation of
the Eastern Shore
Shore Transit
Community Members
Three Lower Counties (TLC)
St. James AME Zion Church
Deer’s Head Center
United Health Care
Eastern Shore Area Health
Education Center
Health South Chesapeake Rehab
Holly Center
Wicomico County Department of
Social Services
Wicomico County Detention
Center
Wicomico County Government
Wicomico County Health
Department
Wicomico County Recreation
and Parks
University of Maryland Agriculture Wicomico County Sheriff’s
and Natural Resources
Department
Wesley Temple
Worcester County Health
Department
Wicomico County Board
of Education
108 East Main Street  Salisbury MD 21801
(410) 749-1244  www.wicomicohealth.org