2015 Annual Report - Chippewa County, Wi

2015
Annual Report
Chippewa County Department of Public Health
THIS IS PUBLIC HEALTH
thisispublichealth.org
2015 was a year of quality improvement for the health department.
As a team, our department was awarded Level III status under
Wisconsin Statutes. This status is rewarded to those health
departments that exhibit at least 14 quality programs and services
provided to their citizens within the state’s health plan. It also
requires the director to be pursuing or have a graduate degree.
We hired a consultant to study our home care program to determine
how we can run more efficiently while maintaining quality care. Of
the 35 recommendations received, over 80% have been
implemented. The home care program also received a
citation-free survey result from our state auditors. In the Nutrition Division, WIC went
electronic with E-WIC so we no longer print checks for clients. This increases efficiency and
quality for those in the program. In public health nursing, I am delighted to add that Carol
Meagher, who has 20+ years in public health nursing, stepped into the Public Health Nurse
Manager role in late December.
In all, it was a great year for us; working with our partners to serve our residents better. As I
look to 2016, this department will hire a new director to lead the team towards continued
improvement. In addition, we will need to tackle a growing number of human health hazard
cases, emerging or re-emerging diseases, and increasing numbers of individuals needing
quality home care. Funding is always a challenge in public health, but one we take head on.
We are committed to serving effectively with the resources we have or can obtain without
undue strain on our citizens.
Thank you for the opportunity to serve the population health needs of this county.
Respectfully Yours,
Public Health
Jen Rombalski, RN, BSN
Director/Health Officer
Vision
“Healthy People in
Healthy Chippewa County Communities”
Mission
“To promote and protect health of
people in Chippewa County”
2
Chair: Larry Willkom
Vice Chair: John (Jack) Halbleib
Anson Albarado
Doug Ellis
Jim Fenno
Dr. Laura Isaacson
Mike Leisz
Larry Marquardt
Bill Stimeling
Kathy Cernohous
Judy Fedie
Jim Fenno
Dr. Laura Isaacson
Jim Koehler
Linda Lorentz
Karen Maddox
Carol Meagher
Debbie Odden (Jan-Apr)
Jen Rombalski
Angie Weideman
Sarah Zarbock
The pie chart at left shows the
Department's unaudited
expenditures for 2015. Home
Health Care has 50.43% of the
department's expenditures
with General Public Health
next at 16.28%. The total
expenditures for 2015 was
$3,339,224.02.
3
CHIPPEWA COUNTY DEPARTMENT OF PUBLIC HEALTH EARNS LEVEL III STATUS
The Chippewa County Department of Public Health has
successfully passed the state’s health department review.
As a result, the department will increase their level status
from Level II to Level III.
“Local public health staff help make their community a
healthier place in which to live, play, work, and learn,” said
Karen McKeown, State Health Officer. “The department has
an actively engaged and supportive Board of Health (Health
and Human Services Board), and does an excellent job
of connecting and collaborating with their community
partners to meet health needs in the county.”
Larry Willkom, HHSB Chair (Left); Jen Rombalski, PH
Director; receiving the Level III award from Tim Ringhand,
Division of Public Health Regional Director (Right)
The Wisconsin Department of Health Services is required to formally review the operations of all 88
Wisconsin local health departments at the county or municipality level at least every five years. The review
establishes the health department as a level I, II or III agency. A level I agency meets the minimum
requirements and a level III agency meets the maximum requirements established for a local health
department.
Friend of Public Health
The 10 Essential Public Health Services
Health Department Director, Jen
Rombalski presents the “Friend of
Public Health” award to Marcia Kyes
In 2015, the “Friend of Public
Health” award recipient was
Marcia Kyes, RN, Pediatric Nurse
Care Coordinator at the Chippewa
Marshfield Clinic. Ms. Kyes’
compassion, knowledge,
experience, and successful
advocacy for improving the health
and ongoing care for children
including those with special health
care needs, makes her an
outstanding community partner
with Public Health.
The 10 Essential Public Health Services describe
the public health activities that all communities
should undertake and serve as the framework
for the National Public Health Performance
Standards (NPHPS) instruments.
4
United Way Partnerships
In 2015, Public Health collaborated with two other agencies, Family Support Center and Eau
Claire City-County Health Department, to apply for and receive United Way funding to create
two new initiatives for Chippewa County residents.
Western Region Nurse-Family Partnership
A voluntary, free maternal and childhood health program, Nurse-Family
Partnership gives first-time moms valuable knowledge and support
throughout pregnancy and until their babies reach two years of age.
Partnering first-time moms with caring nurse home visitors empowers
these mothers to confidently create a better life for their children and
themselves.
Bright Starts S.M.I.L.E. Program
River Source Family Center Parent Educators along with Chippewa County
Public Health nurses partnered to receive a United Way grant to provide
families with a Bright Start. This program was created to provide a S.M.I.L.E.
to parents and children and give them opportunities to shine brightly in all
areas of their life. Personal parents as teacher’s visits from parent educators,
parent group connections, screenings, and assistance with resources are just
a few things our new initiative will offer to parents.
Charity Outreach
Thanks to the Chippewa Dental Foundation!
Chippewa County Public Health received $3,000 to
purchase oral health supplies for Women, Infants, and
Children (WIC) families, Prenatal Care Coordination
(PNCC) clients, Nurse-Family Partnership (NFP)
families, along with other families in need of oral
health supplies.
Since 1998, Chippewa County
Public Health has received funds
from Rutledge Charities to assist
clients who “fall through the
cracks” of the health care system.
Assistance with prescription
medications is the most common
identified service. In 2015, help
was given to 13 clients.
5
Chippewa
County
Adults at Risk
Interdisciplinary
Team
Western WI
Public Health
Readiness
Consortium
Child Death
Review
Multidisciplinary
Team
Children,
Youth &
Families
Committee
Western
Region
Recovery &
Wellness
Consortium
Mentoring/
Workforce
Development
Chippewa
Health
Improvement
Partnership
United Way
Committees
Drug
Endangered
Children
Prevent
Suicide
Nutrition
Advisory
Council-ADRC
HSHS St.
Joseph’s
Hospital
Advisory
Council
Local
Emergency
Planning
Committee
HealthWatch
Chippewa
Valley Care
Coalition
6
Public health nurses comprise the largest professional segment of the public health workforce.
They have an essential role in improving the population’s health and delivering essential health
services to individuals, families and communities where they live, work, learn and play.
Prenatal Care Coordination (PNCC)
By The Numbers
549
Children Received Fluoride
to Prevent Tooth Decay
(Supplements & Mouth Rinse)
1391
Public Health Nurses help pregnant women get the
support and services they need to have a healthy
pregnancy and baby. PNCC services may include:
•
Monthly visits and personal support
•
Alcohol & tobacco prevention/intervention
•
Preparation for caring safely for baby
In 2015, 51 pregnant women were served through PNCC.
Up-to-Date Immunizations by Age 2
In Chippewa County, 77% of children were up to date with their
immunizations by age two. The State average is 70.5%.
Public Health Nurse Visits
1134
Immunizations Given
Served 841 People
0
WI WINS
Youth Tobacco Sales
by Retailers
168
Cases of Chlamydia Disease
BRIDGES -
Building Responsible Individuals, Dual Protection,
Guidance, Education, and Support
This program aims to “dual protect” against an unwanted
pregnancy and getting a sexually transmitted disease.
•
42 Chlamydia tests given
•
13 people treated with antibiotics
•
99 Plan B given
•
2,250 Condoms Provided
•
19 Pregnancy Tests
7
Communicable Disease Control
In 2015, 715 cases of diseases were
reported. As a result of follow up, 403
were confirmed cases, 268 were not a
case, and 44 were suspect cases.
Emerging & Re-emerging Infectious Diseases and Local Public Health
New diseases are arising and old diseases are re-emerging as infectious agents evolve and spread as
changes occur in ecology, socioeconomic conditions, and population patterns. In 2015, public health staff
were involved with several emerging and re-emerging diseases including Avian Influenza, Ebola, and
Tuberculosis.
 Avian Influenza
In April 2015, Public Health was notified of a turkey farm in Chippewa County with birds that tested
positive for HPAI H5 influenza. This is a novel (new) influenza virus that has not been found to be
transferred to humans. Public Health monitored workers who had been in contact with the affected birds
offering treatment and education. State and local agencies, along with the business and their employees,
worked closely together on this situation.
 Ebola
Since March 2014, West Africa has experienced the largest outbreak of Ebola in history. The Centers for
Disease Control and Prevention (CDC) and partners have worked to contain this epidemic at its source.
Local public health agencies monitored returning travelers from designated high risk areas as well as
increased our communication with our emergency response and hospital partners.
 Tuberculosis (TB) and Latent Tuberculosis
After two decades of progress toward TB elimination, it appears TB disease and infection is
leveling off. It is important for local public health departments to closely monitor
TB activity in their communities. Chippewa County has seen an increase in
TB infection in 2015 with seven cases identified and case management
services provided, including directly observed therapy (DOT). We also
provided DOT to one case of TB disease.
8
Access to home health care in Chippewa County is enhanced by our Home Health Care
program and services. Through skilled nursing, personal care, and speech, occupational and
physical therapy, individuals can recover safely at home, right where they want to be.
The Home Care program has been serving clients
in Chippewa County for 49 years…
By The Numbers
268
“We are thankful, as
the nurses and home
health aides go over
and above with extras
for our mother.”
--Mary Beth Ebben
Anna Jaenke, HHA (left) Margaret
Ebben, and Rachel Potaczak, RN (right)
Home Care Survey
On December 3, 2015, surveyors from
the Division of Quality Assurance,
Bureau of Health, completed a recertification
survey at our agency to review continued compliance
with WI Administrative Code DHS 133 and the Federal
Conditions of Participation for Medicare/Medicaid.
Our agency was found to be in compliance and no
citations were issued!
Unduplicated People
Served
79
Average Age of Home Care
Client
2353
Nursing Visits
0
Home Care Survey Citations
3627
Aide Visits
469
During 2015, the Home Care staff and Administrative staff
have phased in electronic forms creating efficiencies.
Additionally, we began electronically communicating
referrals with physicians and therapists, thus speeding the
process of admitting/discharging of patients. This process
also helped us to communicate with hospitals and payors
regarding services.
People Served at
57 Foot Clinics
649
Durable Medical Equipment
Items Loaned Out
9
Home Care Star Rating
The Centers for Medicare and Medicaid (CMS) have
come out with a new star rating system for home
health providers. The ratings assess quality of patient
care and will incorporate patient survey data in 2016. Chippewa County Home Care received 3 stars. The
ratings summarize an agency’s average performance across nine publicly reported quality measures.
These measures include the following:
Process Measures
1. Initiated patient care in a timely
manner.
2. Provided patient/caregiver drug
education on all medications.
3. Ensured patients received flu vaccine for
the current season.
Outcome Measures
4. Got better at walking or moving around.
5. Got better at getting in and out of bed.
6. Got better at bathing themselves.
7. Was able to engage in activity with less
pain.
8. Experience less shortness of breath.
9. Required acute care hospitalization.
Home Health Consumer Assessment of Healthcare Providers & Systems (HHCAHPS)
HHCAHPS is the first national standardized and publicly-reported survey of home health care patients’
perspectives of their skilled homecare. It is designed to measure the experiences of people receiving
home health care from Medicare certified home health agencies.
HHCAHPS is a 34-item questionnaire and data-collection methodology to measure patients’ perceptions of
their skilled home care. There are 25 “core questions” and 9 “about you” questions on the survey.
Questions cover topics such as communication about care, pain, prescription medication use, the care
received from the home health agency, staying informed about scheduling, and global ratings. Areas
combined for rating include: Care of Patients, Communication between Providers and Patients, and
Specific Care Issues. See the results for the Specific Care Issues Composite below for January 1 through
December 31, 2015. Chippewa County Home Care exceeded the national average!
10
Environmental health professionals prevent and promote health through inspections of human
health hazards, management of elevated blood lead levels in children, and enforcement of
applicable codes for various facilities in Chippewa County. The goal of the program is to reduce
exposure to food-borne, water-borne or recreational hazards in the community.
Inspection Reports Available Online
By The Numbers
628
Facility Inspections
Conducted
Restaurant inspections are now online
for public viewing. Search Chippewa
County Public Health and click on the
Food Safety and Recreational Licensing
tab and type in a restaurant you would
like to view the latest inspection on.
38
Human Health Hazard
Inspections
59%
Radon Test Results with
High Levels
(99 samples tested)
14
Children (less than age 5)
Received Lead Case
Management
10
Recommended Beach
Advisories or Closures
(10 Beaches regularly tested)
Chippewa County Public Health was able to investigate and
confirm a foodborne outbreak in June 2015 from a catered
wedding reception. The State Department of Health along with
the State Department of Epidemiology worked closely with
Chippewa County Environmental Health staff and verified a
Clostridium perfringens strain resulted in 75 people becoming ill.
The importance of this collaboration indicated we were able to
conclude with the caterer what the cause of the outbreak was and
provide guidance to see it doesn’t happen again.
11
Public health nutrition focuses on emphasizing the application of food and nutrition
knowledge, policy, and research to the improvement of the health of populations.
“Making the Healthy Choice the Easy Choice”
Women, Infants and Children
Women, Infants and Children (WIC) is the public health
nutrition cornerstone for building healthier women,
infants, children, families and communities.
In 2015, Wisconsin implemented eWIC, a paperless and
convenient way for families to purchase their healthy
WIC-approved foods using an electronic benefit card.
As a result, utilization of the WIC fruit & vegetable
benefit increased and errors resulting in purchase of
unauthorized foods decreased.
By The Numbers
1051
Contracted monthly WIC
Program caseload
1723
Unduplicated number of
women, infants, and children
served
Breastfeeding Peer Counselor Program
The WIC Program continues mother-to-mother support
for breastfeeding by pairing mothers with a
Breastfeeding Peer Counselor.
•
All but one of our breastfeeding outcome
measures in 2015 exceed WI State outcome
measures. Thirteen percent of our WIC-enrolled
moms breastfed to one year or longer while
fifteen percent of all WIC moms in the state
breastfed to one year.
95%
WIC-enrolled babies were
born weighing > 5.5 pounds
81%
Babies Start Out Breastfeeding
40%
Continue 6 months or longer
$835,700+
Revenue to Chippewa County
WIC Program Vendors
•
In 2015, 52 women received peer counselor
breastfeeding support.
12
Challenge Chippewa
This is the nutrition and physical activity action team of the Chippewa Health Improvement
Partnership (CHIP). Challenge Chippewa completed a new strategic plan for 2015-2018. The
overall goal is to create an environment in Chippewa County that supports and empowers
every resident to make healthy food and beverage choices and to create an environment for
Chippewa County residents that makes physical activity an easy, desirable, affordable, and
accessible choice for all. The Places to Play Guide was promoted (available at
http://www.co.chippewa.wi.us/government/public-health ). During routine well-child care,
Sunrise Family Care Clinic, a partner member of Challenge Chippewa, routinely screens for
sugar-sweetened beverage consumption and distributes books provided by CHIP titled Potter
the Otter Drinks Water.
Fit Families
Fit Families is a successful behavior change program for WIC-enrolled families with 2-4 year old
children, Fit Family Center staff, and the community. Fit Family Care Messages:
•Move More…Watch Less
•Make Every Bite Count…More Fruits/Vegetables
•Make Every Sip Count…More Healthy Beverages
•Eat Healthy, Be Active, Your Kids Are Watching
2014 Fit Family Cohort Outcome Measures
For Children Who Completed, Percent at Recommended Levels at Enrollment and at One Year
Fruit & veg:
≥4/day
Pre
Post
State
Objective
Chippewa
County
Juice:
≤ 6oz/day
Pre
Post
Sweet beverages:
Screen time:
≤1/ week
≤2 hours/day
Pre
Post
Pre
Post
Activity:
≥ 60 min/day
Pre
Post
--
60%
--
75%
--
80%
--
85%
--
N/A
21.4%
57.1%
69.0%
81.0%
66.7%
76.2%
66.7%
92.9%
83.3%
92.9%
Farmer’s Market Nutrition Program (FMNP)
The purpose of the FMNP is to provide WIC-enrolled families fresh,
nutritious, unprepared fruits, vegetables and herbs from approved
Wisconsin farmers markets and farm stands. The WIC FMNP helps grow
community awareness of farm markets, promotes farm to table and eating
local, and increases sales of fruits and vegetables. Authorized Chippewa
County locations included Klinger Farms and the downtown Chippewa Falls
Farmers Market. In 2015, Chippewa County WIC-enrolled families
purchased $3,651 in fresh produce from Wisconsin farmers.
13
The Western Regional Center for Children and Youth with Special Health Care Needs (WRC)
focuses on improving programs and services through promoting family partnership, medical
home connections, adequate and consistent health insurance, early and continuous
screening, accessible community based services, and transition to adult services.
Western Regional Center (WRC)
The WRC served as the single point of intake for Children
with Differing Abilities for
Human Services for the year.
WRC staff provided intake for
children whose families sought
services through Birth to 3 or
disability waivers. The WRC
completed intakes for 269
children with differing abilities, in 2015.
ForwardHealth
In 2015, health department staff assisted potential
participants with applications and renewals for
Wisconsin’s ForwardHealth programs using ACCESS.
ForwardHealth programs include: Wisconsin Medicaid,
BadgerCare Plus (BC+), Family Planning Waiver and
Wisconsin FoodShare. In total 77 ForwardHealth
applications, 53 food share applications, and 69
applications for BC+ or Family Planning Waivers were
completed with/for county residents.
Wisconsin Sound Beginnings
Wisconsin Sound Beginnings (WSB) is
the state’s Early Hearing Detection and
Intervention (EHDI) Program, ensuring
that all babies born in Wisconsin are screened for
hearing loss at birth, receive timely diagnosis of hearing
loss, and are referred for early intervention. One of the
state’s three Regional Outreach Specialists is housed in
the Chippewa County Department of Public Health. In
2015, 97 infants were screened in their homes.
Approximately 94% were out-of-hospital births that in
prior years would most likely have not received
screening.
By The Numbers
18
Regional Local Health
Agency Partners
152
Services Provided to
Children and Youth
2028
Phone Calls for Referral
150
Unduplicated Households
Served by ForwardHealth
97
Infants Screened for
Hearing Loss
14
Recognizing staff with 5 or more years of service
Judy Fedie, Nutrition Div Mgr – 29 Years
James Koehler, EH Coordinator – 28 Years
Carol Meagher, RN – 27 Years
Linda Ellis, RN – 26 Years
Sarah Zarbock, HH Div Mgr – 24 years
Sue Cooley, Admin Asst – 19 Years
Dawn Braden, HH Aide – 18 Years
Cheryl Gast, Account Asst – 18 Years
Rose Marsh, Program Consultant – 16 Years
Linda Gilson, RN LTE – 15 Years
Audra Knowlton, Admin Asst – 15 Years
Stephanie Abbe, Nutritionist – 13 Years
Dierdra Lancor, HH Aide – 13 Years
Tanya Sly, Account Asst – 12 Years
Anna Jaenke, HH Aide – 11 Years
Bridgette Stafford, RN – 11 Years
Linda Andresen, LPN – 9 Years
Kim Hoffman, RN – 9 Years
Jenny Lenbom, RN – 9 Years
Pat Westaby, RN – 9 Years
Congratulations for a combined 331 years of service to Chippewa County!
Level III Health Department
Successful Fit Families Audit
Citation-free Home Care Survey
eWIC Implementation
Nurse Family Partnership Program
Department Marketing Plan
Department Comprehensive Communication Plan
Electronic Health Record Implementation
Performance Management Plan
Question, Persuade, Refer (QPR) Suicide Prevention
Chippewa County Department of Public Health
711 N Bridge Street Room 121, Chippewa Falls, WI 54729
Phone: 715-726-7900 Fax: 715-726-7910
Hours: Monday – Friday, 8:00 a.m. – 4:30 p.m.
www.co.chippewa.wi.us/ccdph
15