Report to the Board of Health – January 2017

Winnebago County Health Department Leadership Team • Cheryl Floyd, MSEd – Center Director, Health Promotion and Wellness • Melinda Idell, RN, MSN – Center Director, Personnel Health Services • Theresa James, CHEC III – Center Director, Public Health Preparedness • Todd Kisner, MPH – Center Director, Health Protection • Patrick Madigan – Finance Director • Todd Marshall, BS, LEHP – Center Director, Environmental Health Improvement • Sue Merchen BA, – Public Information Officer • Karalyn Nimmo, MPH – Data and Quality Coordinator

• Domain I – Monitor Health

Environmental Health Improvement (EHI) continues to monitor for critical violations for all EH programs to identify areas where more education is needed for food operators, contractors, and landlords.

Indoor Air Monitoring for month of January 2017

Month Fiscal Month Fiscal January Year January Year to Date 2017 To Date 2016 2016 Air Quality Inspections Performed 4 17 3 16

CO2 (PPM) Average 595 803 969 795 Max 958 1766 2130 1287 Temperature (F) Average 71.8 69.4 69.5 70.5 Max 78.4 79.6 77.8 83.7 Humidity (%RH) Average 15.0 37.4 33.2 40.8 Max 18.9 64.6 44.0 79.7 CO (PPM) Average 0.7 0.8 0.9 0.6 Max 1.5 6.8 1.0 2.3

Homes with at least one reading CO2 0 6 2 6 Exceeding guideline: CO 0 0 0 0 with at least one reading CO2 0 3 1 2 Exceeding guideline: CO 0 0 0 0

Radon January was Radon Awareness Month and the media attention and outreach was a success by dramatically increasing the number of radon test kits sold to the public. Staff have met to plan for the application for funding through the Federal Environmental Protection Agency (EPA) to address Board of Health Report January 2017 - Page 2 of 21

radon public education, testing, and mitigation. The number of screenings as compared to January 2016 increased by 67%.

Month Fiscal Year Month Fiscal Year

January To Date January To Date

2017 2017 2016 2016

Radon Screenings 10 20 6 7

Average (pCi/L) 7.3 6.7 1.4 1.5

Max (pCi/L) 15.9 16.8 3.2 3.2

Radon Test Kits Purchased 26 29 0 0

Average (pCi/L) 6.6 5.8 n/a n/a

Max (pCi/L) 17.6 17.6 n/a n/a

Phone Calls 24 40 25 29

Units Reported as mitigated 4 4 1 1

The EPA strongly recommends that homeowners install radon mitigation in homes at or above 4.0 pCi/L, and that homeowners should consider mitigation at levels between 2.0 and 4.0 pCi/L.

Mosquito Surveillance and Control Program budget has been reviewed to confirm available funds for a spring tire drive. Staff are currently developing plans for the tire drive, including the securing of a contractor and determining the time and location for the event.

Illinois Youth Survey (IYS)

The new ATOD Prevention Specialist, Alyssa Lazzerini, will be reviewing and providing a summary to the Winnebago County Health Department leadership and the Winnebago County Substance Abuse Prevention Coalition (WCSAPC) regarding trends of youth substance abuse based on local and state assessments such as the Youth Survey and her training as an Access Specialist at Rosecrance, Inc. Information presented will help begin the process for recruiting more community partners to the WCSAPC.

Board of Health Report January 2017 - Page 3 of 21

Sexually Transmitted Infections (STIs)

*“STIs Seen” represents treatment and/or diagnosis in WCHD Clinical Service

STIs Seen Through WCHD 2016 Year 2015 Year YTD 2017 Clinical Services Total Total Chlamydia 1 122 197

Gonorrhea 1 66 75

HIV 0 2 2

HPV 0 2 44

Syphilis 0 12 9 Oher (bacterial vaginosis; cervicitis, 43 503 773 NGU; PID and yeast infection)

Whether seen in WCHD Clinical Services or by a community healthcare partner, Sexually Transmitted Infections (STI) are reported to the Communicable Disease Department for surveillance and treatment verification. In the event that an individual did not received treatment for the STI, WCHD will provide the necessary treatment for the STI.

For a complete report on all STIs reported for Winnebago County including the WCHD Clinical Services, please review the Communicable Disease Report in Domain 2.

Board of Health Report January 2017 - Page 4 of 21

• Domain 2 – Diagnose and Investigate

CLSR (Creating Lead Safe Rockford) 2016 Contracts for lead mitigation work and training were approved by the Board of Health. Approving work for individual units is now underway. Benchmarks for unit enrollment and inspections are ahead of schedule.

CLSR (Creating Lead Safe Rockford) 2016 objectives

Goal Actual Percent Units Enrolled 175 38 21.7% Inspections 165 28 16.9% Mitigated Units 150 0 0

Testing Lead in Water

Month FY 2017 January Samples Taken & Analyzed: 9 17 Number exceeding EPA/IL lead hazard level: 0 0 Average lead content 3 ppb 2 ppb Maximum lead content 6 ppb 6 ppb

Food Complaints

Month FY 2017 FY 2016 January # of Foodborne Illness Complaints 3 7 11 # of Foodborne Illness Investigations 3 7 11 # of Non-foodborne Illness Complaints 17 46 39

Housing Complaints Month FY 2017 FY 2016 January # of Housing Complaints 61 256 222 # of Nuisance Complaints 17 53 35 # of Survey Complaints 5 17 146 # of Received Complaints 83 338 416 # of Re-check on Complaints 141 1111 1348

Well and Septic Complaints

Original Recheck FY17 FY17 FY16 Original FY16 Recheck complaints complaints Original Recheck complaints complaints complaints complaints Wells 1 1 2 3 8 8 Septic 1 1 4 5 8 5

Board of Health Report January 2017 - Page 5 of 21

Communicable Diseases

2017 YTD January Investigated 2016 Year 2015 Year 2017 YTD 2017 & Total Total Vaccine Preventable Diseases Confirmed Confirmed Determined Confirmed Confirmed (Reporting timeframe) Cases Cases "Not a Cases Cases Case"

Chickenpox (Varicella) (24h) 0 0 0 0 2 Diphtheria (immediate) 0 0 0 0 0 Haemophilus influenzae, invasive (24h) 1 1 1 7 5 Hepatitis A (24h) 0 0 0 2 0 Hepatitis B-Acute Infection (7d) 0 0 0 2 1 Hepatitis B-Chronic (7d) 0 0 0 21 2 Hepatitis C-Acute (7d) 0 0 0 0 1 Hepatitis C-Chronic (7d) 14 6 14 142 239 Hepatitis D (7d) 0 0 0 0 1 Influenza deaths in < 18 yrs old (7d) 0 0 0 0 0 Influenza A, variant (immediate) 0 0 0 0 0 Influenza, ICU admissions (24h) 4 2 4 3 6 Measles (rubeola) (24h) 0 0 0 0 0 Mumps (24h) 0 0 0 0 0 Neisseria meningitidis, invasive (24h) 0 0 0 1 0 Pertussis (whooping cough) (24h) 0 0 0 5 9 Polomyelitis (immediate) 0 0 0 0 0 Rubella (24h) 0 0 0 0 0 Streptococcus pneumoniae, invasive disease, in those < 5 yrs old (7d) 0 0 0 0 3 Tetanus (7d) 0 0 0 0 0 Sexually Transmitted Infections AIDS (7d) 0 0 0 0 11 Chancroid (7d) 0 0 0 0 0 Chlamydia (7d) 198 2 198 1856 1751 Gonorrhea (7d) 54 0 54 709 544 HIV infection (7d) 3 0 3 2 18 Syphilis (7d) 0 0 0 15 22 Other Communicable Diseases Anaplasmosis (7d) 0 0 0 0 0 Any suspected bioterrorist threat (immediate) 0 0 0 0 0 Any unusual case or cluster of cases that may indicate a public health hazard (immediate) 0 0 0 0 0 Anthrax (immediate) 0 0 0 0 0 Board of Health Report January 2017 - Page 6 of 21

Arboviruses (7d) 0 0 0 0 0 Babesiosis (7d) 0 0 0 0 0 Botulism, foodborne (immediate) 0 0 0 0 0 Botulism, infant, wound, other (24h) 0 0 0 0 0 Brucellosis (24h unless bioterrorism suspected, then immediate) 0 0 0 0 0 Campylobacteriosis (Became Reportable in 2016) 4 0 4 38 n/a Chikungunya Non-neuroinvasive Disease (7d) 0 0 0 1 0 Cholera (24h) 0 0 0 0 0 Creutzfeldt-Jakob Disease (7d) 0 0 0 0 0 Cryptosporidiosis (7d) 1 1 1 26 5 Cyclosporiasis (7d) 0 0 0 0 0 Dengue (7d) 0 0 0 0 0 Drug-resistant organism, extensively (7d) 0 0 0 0 0 Ehrlichiosis (7d) 0 0 0 0 0 Enteric E. coli infections (STEC,O157:H7, ETEC, EPEC, EIEC) (24h) 0 0 0 8 7 Foodborne or waterborne outbreaks (24h) 0 0 0 0 0 Hantavirus pulmonary syndrome (24h) 0 0 0 0 0 Hemolytic uremic syndrome, post diarrheal (24h) 0 0 0 0 0 Histoplasmosis (7day) 0 0 0 0 0 Legionellosis (7d) 0 0 0 4 8 Leprosy (7d) 0 0 0 0 0 Leptospirosis (7d) 0 0 0 0 0 Listeriosis (7d) 0 0 0 2 0 Lyme disease (7d) 0 0 0 8 7 Malaria (7d) 0 0 0 1 1 Ophthalmia neonatorum (gonococcal) (7d) 0 0 0 0 0 Outbreaks of public health significance (24h) 0 0 0 0 0 Plague (immediate) 0 0 0 0 0 Psittacosis (7d) 0 0 0 0 0 Q fever (24h unless bioterrorism suspected then immediate) 0 0 0 0 0 Rabies, human and potential human exposure and animal (24h) 0 0 0 8 16 Reye syndrome (7d) 0 0 0 0 0 Salmonellosis, other than typhoid (7d) 2 0 2 42 57 Severe Acute Respiratory Syndrome (SARS) (immediate) 0 0 0 0 0 Shigellosis (7d) 0 0 0 99 116 Smallpox (immediate) 0 0 0 0 0 Board of Health Report January 2017 - Page 7 of 21

Smallpox vaccination, complications of (24h) 0 0 0 0 0 Spotted fever rickettsioses (7d) 0 0 0 0 0 S. aureus, Methicillin resistant (MRSA) clusters (two or more lab confirmed cases) in a community setting (24h) 0 0 0 0 0 S. aureus, Methicillin resistant (MRSA) in infants <61 days (24h) 0 0 0 4 9 S. aureus infections with intermediate or high level resistance to vancomycin (24h) 0 0 0 0 0 Streptococcal infections, Group A, invasive including STSS and necrotizing fascitis (24h) 2 1 2 8 11 Toxic shock syndrome due to S. aureus (7d) 0 0 0 0 0 Trichinosis (7d) 0 0 0 0 0 Tuberculosis (7d) 0 0 0 0 0 Tularemia (24h unless bioterrorism suspected then immediate) 0 0 0 0 0 Typhoid fever (24h) 0 0 0 0 0 Typhus (24h) 0 0 0 0 0 Vibriosis (non cholera) (7d) 0 0 0 1 2 Yersiniosis (7d) 0 0 0 0 0 West Nile Fever (7d) 0 0 0 0 0 Zika Virus 0 0 0 1 n/a

The above table represents only those reportable diseases that have been received this month and year to date in comparison to the previous two year totals.

* ”Investigated & Determined Not a Case” Column indicates an investigation was completed on a “probable” case of the disease noted. As the final diagnosis was not the specified disease, then the investigation work falls in this reporting category.

Communicable Disease Activities Emerging Disease – Seoul Virus Seoul virus is a virus carried by brown or Norway rats. It is a milder type of a Hantavirus. People can become infected with this virus after coming into contact with urine, droppings, or saliva of infected rats. Seoul virus is not known to be transmitted from person to person.

Symptoms may include fever, severe headache, back and abdominal pain, chills, blurred vision, redness of the eyes, or rash. In severe cases, infection can also lead to acute renal disease. However, not all people infected with the virus experience symptoms. Six of the seven Illinois cases showed no signs of illness. Wisconsin has three confirmed Seoul Virus cases. Board of Health Report January 2017 - Page 8 of 21

The Communicable Disease Team is working closely with the Illinois Department of Public Health, the Centers for Disease Control and Prevention to investigate the source of these Seoul virus infections, coordinate testing, and prevent possible future cases. To date, the Team has investigated two potential cases of Seoul Virus.

Seasonal Influenza Surveillance: On February 9, 2017, the Public Health Administrator, Dr. Martell, based on the influenza surveillance activity through Week 5, recommended that the mutually adopted Infection Control Practices for Influenza (including visitor restrictions and work force policies that address unvaccinated staff) be implemented as soon as possible within each agency. All health systems in the Rockford area (Winnebago County area) should restrict visitors under the age of 18 years. A joint press release was sent to the media indicating the implementation of these actions.

The data used to make the recommendation can be summarized below:

U.S. – The Centers for Disease Control and Prevention (CDC) reports a continuing increase in influenza activity throughout the nation, consistent with increasing activity to be expected in the coming weeks. Widespread influenza activity is now reported in 40 states, including Illinois as of the week ending January 28, 2017 (Week 4).

Illinois – Illinois is reporting widespread influenza activity with 2.61% (baseline 1.9%) of outpatient visits for Influenza-Like Illness (ILI) during Week 4.

Local (Winnebago County) – ILI reported from sentinel sites through BioSense Syndromic Surveillance System increased to 2.27% (baseline 1.9%) of emergency department (ED) visits for Week 5. This is an increase compared to Week 4 having 1.64% of ED visits for ILI. Influenza cases reported to the Health Department are on the rise:

Cases of Influenza % Increase from Week Ending (CDC Week) Reported Previous Week January 21, 2017 (Week 3) 70 January 28, 2017 (Week 4) 103 47% February 4, 2017 (Week 5) 183 78%

The CD Team continues it surveillance efforts with seasonal influenza. Influenza surveillance for Winnebago County involves the weekly collection of data from surveillance partners including , physicians, clinics, long term care (LTC) facilities and laboratories. As of February 4, 2017, Winnebago County has seen a total of 467 influenza cases for the season.

To view each of the weekly Influenza Surveillance Reports, please go to the WCHD website at http://www.wchd.org/index.php?option=com_content&view=article&id=654&Itemid=1152

Board of Health Report January 2017 - Page 9 of 21

• Domain 3 – Inform, Educate, and Empower

Posting Food inspection Results on Website The Quality Improvement Food Project committee has completed their evaluation/assessment regarding 2 different methodologies on displaying information on inspection reports on the website: (1) grading system or (2) posting observed violations. There are many “pros” and “cons” using an equitable grading system. The committee’s sponsor would like to present our assessment to the Quality Improvement committee of the Board of Health in March 2017 for their input and guidance as the project moves forward.

Neighborhood Property Standards Education Initiatives Training is underway for the new Code Enforcement staff member. Additionally, staff are implementing new enforcement procedures for vacant and blighted homes, as adopted in the 2016 Property Maintenance Code revisions

Prairie Road Pump Neighborhood Association Presentation On February 3rd, the WCHD reached out to them for a status update. Winnebago County Health Department (WCHD) was informed that the Homeowner’s Association Board (HAB) has been disbanded due to the lack of participation. As a consequence, additional funds have not been collected by the HAB to build reserves to demonstrate commitment to the Illinois Environmental Protection Agency (IEPA) on repaying the 20 year low-interest loan. WCHD has advised the remaining members to reconnect with IEPA recommendations and guidance to address the water issue.

Board of Health Report January 2017 - Page 10 of 21

Substance Abuse Youth Prevention Education The new ATOD Prevention Specialist, Alyssa Lazzerini has begun to plan and implement deliverables from the Department of Human Services (DHS) Substance Abuse Prevention Program grant which includes the implementation of the ALL STARS evidence- based curriculum at the Middle School level. Ms. Lazzerini will complete the training in the All Stars Curriculum in March, 2017. Outreach to schools will begin in March to discuss opportunities and scheduling for the Fall Semester of 2017. Summer groups will be offered to several community centers and organizations that provide summer programming to school-age children.

Adolescent Health: Primary Prevention thiNk (Teen Pregnancy Prevention) The Teen Pregnancy Prevention Specialist met with 34 students from five (5) Middle Schools within the Rockford Area. Three (3) out of the 5 school groups completed the program with over 80% attendance rate for the entire semester. The Prevention Specialist continues to provide informational tips for parents of teen group members. Prevention Specialist is preparing for Teen Pregnancy Prevention Awareness Day in May, 2017.

The Prevention Specialist provided 2 presentations this past month for a total of 17 youth and community leaders combined. Thirteen education sessions were provided within the family planning clinic, or other organizations.

THAT Coalition (Teen Health Advisory Team)

The coalition is currently working towards partnering with the Rockford Regional Health Council’s Teen Pregnancy Prevention efforts to collaborate on community efforts to decrease teen pregnancy rates. This collaboration may provide an opportunity for coalition members to connect with a larger organization to continue and sustain current efforts in teen pregnancy prevention programming.

Planning has begun for a Girl Leadership Empowerment program to be provided in early May with the partnership of KFACTS (Keeping Families and Communities Together) organization (www.kfacts.org).The program will be held on a weekend at a local hotel or conference center and will include speakers, small group activities, and friendship activities. The goals of the program are to 1) increase awareness of self confidence and self care for young women, 2) equip students with the knowledge and skills to make safe and healthy choices regarding sexual health, education, and career goals; and 3) engage young women in opportunities available to them within the community that can help them to succeed in life.

Board of Health Report January 2017 - Page 11 of 21

Radon Awareness Month During Radon Awareness month in January, the Public Information Officer (PIO) along with the Environmental Health Staff coordinated a month long media campaign to inform and educate the public about the dangers of radon exposure. The campaign consisted of a news release, media interviews, web and social media postings and radon test kits for purchase. The campaign was very successful with a reach of over 550 on Facebook and 2,900 on Twitter. Two media outlets covered the story, and as a result 26 radon test were sold. West Nile Virus Annual Report In January the PIO sent out the 2016 West Nile Virus Annual Report for 2016. The report was sent to local and state partners along with several municipalities. The report was also posted on the WCHD website and had a reach of over 380 on Facebook and over 780 on Twitter. Electronic and Social Media Stats for January 2017

January 2017

WCHD Website Page 10,622 Page Views 3,999 Sessions 3,156 Users Facebook 564 Avg. Weekly Reach 36 Avg. Weekly Engagements 655 Total “Likes” Twitter 22.2K Tweet Impressions 4 New “Likes” – 112 Total 766 Followers Intranet Page NA Page Views NA Sessions NA Users

• Domain 4 – Mobilize Community Partnerships

Wellness Focused Winnebago County The three (3) Community Advisory Groups (CAG) addressing the health priorities were convened and began their work to assist in development of the action plans for the Winnebago County Health Department (WCHD) Wellness Focused Winnebago County IPLAN. The community groups for the priorities are as follows:

o Maternal and Child Health: The Early Childhood Learning Council of the Rockford Area (ECLCRA) and the Rockford Regional Health Council o Mental/Behavioral Health: Mental Health Advisory Committee o Violence: Violence Reduction Workgroup

The formal Steering Committee incorporating representatives from the three CAGs, WCHD internal IPLAN Steering Committee, and the WCHD Strategic Plan Goals had their first meeting on December 7th to outline the purpose of the Steering Committee and review the activities to date.

Board of Health Report January 2017 - Page 12 of 21

Rock River Homeless Coalition On January 23, 2017, Dr. Martell and Todd Kisner participated along with community volunteers in the Rock River Homeless Coalition annual Point-in-Time (PIT) count of the homeless in the community. The (PIT) count is a count of sheltered and unsheltered homeless persons on a single night in January. Housing and Urban Development (HUD) requires that Continuums of Care conduct an annual count of homeless persons who are sheltered in emergency shelter, transitional housing, and Safe Havens on a single night. Volunteers braved the cold weather on the Monday night beginning at 7:00 PM to count those individuals experiencing homelessness. These volunteers interviewed each individual with a short survey on the length of time he, she or the family have been homeless. Through the efforts of these volunteers, individuals experiencing homelessness were found living in camps in the cold weather, on the street in front of the public safety building, parking garages, and unofficial shelters.

Business First The Illinois Department of Commerce and Economic Opportunity (DCEO) attended the January 24th meeting of Business First. The DCEO was interested in learning how Business First assists and educates potential business owners. Winnebago County Health Department continues to advocate for the inclusion of communities outside of the City of Rockford in this City-County initiative.

Center for Community Progress The WCHD has continued to receive Freedom of Information requests for properties in the Kishwaukee School area. The CSLR 2016-2017 program has included Community Development plans into its property review process to ensure that properties in these areas are not subject to demolition plans prior to awarding of grant funds.

Substance Abuse Prevention Coalition The Winnebago County Substance Abuse Prevention Coalition is currently working with the National Guard to devise a plan that will include assessing current statistics and data by the Illinois Youth Survey and other tools that provide selected trend information about youth substance abuse; develop a new mission statement and information about the coalition; recruit more coalition members that will model community capacity building; train new members in the development of a Strategic Prevention Framework Evidence Based Coalition model; and develop and implement awareness education campaigns and tools that communities especially parents can use to increase their knowledge about youth substance abuse prevention and intervention resources. The National Guard has been involved for several years with communities throughout the State of Illinois with assisting communities in developing and implementing Drug Free Communities. Board of Health Report January 2017 - Page 13 of 21

The representative from the National Guard will assist our Prevention Specialist in organizing data, understanding trends, and developing the recruitment and training for coalition members.

Drug Overdose Prevention Program Winnebago County Health Department (WCHD) was notified that it would be receiving funding to implement a Drug Overdose Prevention Program (DOPP). The DOPP has three major components including: education regarding opioid abuse and prevention including the use of naloxone for rescue, expanding the availability of naloxone in the community to trained individuals, and conducting surveillance on the use of naloxone including outcomes. WCHD reached out to Hope Over Addiction, Rosecrance, and Remedies to develop the community education strategy and the University of Illinois College of Medicine and Pharmacy in Rockford to develop the distribution and surveillance components. The DOPP program will be integrated into the Center for Health Promotion and Wellness. The community partners have met to begin the process of developing this important system of care.

Transform Rockford Dr. Martell continued to represent the Winnebago County Health Department on the Transform Rockford (TR) Healthy Lifestyles workgroup. The workgroup has taken on 21 as a policy initiative with the Winnebago County Health Department and has started to organize within the workgroup to understand how Tobacco 21 has been accepted and implemented in other Illinois communities. The Chicago Department of Public Health, Trinity Healthcare, American Heart Association, and American Lung Association are providing guidance as the local team moves through the process. A Tobacco 21 policy would have significant positive impacts on the community including health, economics, and perception.

Foods Workgroup The workgroup consisting of representatives Gary Anderson (Gary Anderson Architects), Matt Idzikowski (Vintage @ 501, Blue Line Sports Pub), Chris Manuel (Prairie Street Brewing Company), and Ed McCullough (the Element) continued to meet to review concerns related to the Food Safety Code and its implementation in Winnebago County and the workgroup was instrumental in providing recommendations and feedback on the how to present to the elected officials and the community stakeholders.

Board of Health Report January 2017 - Page 14 of 21

• Domain 5 – Policies and Plans

IPLAN 2020 – Wellness Focused Winnebago County The Wellness Focused Winnebago County IPLAN 2020 is complete and posted on the the health department website. Readers may download a copy of the doucment. Community partners and residents will be notified of the doucment and the health priorities. Goal Team 3 of the strategic plan goal groups is tasked with this action. The Goal Team is searching for effective mediums to communicate the information. Thank you to everyone who has helped to make this IPLAN complete.

Wchd.org

• Domain 6 – Enforce Laws

EHI Code Enforcement Stats

January 2017 FY 2017 FY 2016 Inspections Inspections Inspections Foods 306 1080 1221 Wells 4 20 40 Septic 2 36 34 Loan Inspection 41 195 138

Board of Health Report January 2017 - Page 15 of 21

Administrative In-House Administrative In-House FY 2016 FY 2016 Hearings Hearings Hearings Hearing Administrative In-House January January (FY17) (FY17) Hearings Hearing Housing 1 2 9 47 33 102 Foods 0 2 0 3 0 11 Well/Septic 0 0 0 0 2 6

Report of Food Facility In-house hearings 1. Stone Wall Café 423 Main Street; Pecatonica, IL 61063 Date: 1.24.17 Violations: Date marking, repair/maintain sink drain, splash guard between hand sink and 3 compartment sink.

2. Fair Oak Retirement Center 1515 Blackhawk Boulevard; Rockford, IL Date: 1.31.17 Violations: Proper cooling, hand washing, requirement of a mixing faucet, cleaning schedule, and wall repair.

Illinois Tobacco Free Communities/Smoke-Free Illinois Act (SFIA) Alisen O’Hearn is the new Tobacco Free Communities Prevention Specialist who will begin to work with businesses and community organizations to increase their knowledge about the Smoke Free Illinois Act; tobacco policies including the Tobacco 21 initiative; increasing the number of healthcare providers and organizations who work with individuals who use tobacco and how to refer users to the Tobacco Quitline. With the assistance of a Student intern, there is the potential of providing free cessation programming and development of a media campaign targeting women who smoke.

Two (2) visits to local businesses took place in January based on complaints to the Smoke Free Illinois Act online submission. Information and Warning letters were sent and discussion with business owners has also taken place. Further investigation with local ordinances to determine exemption status for one business will be included in February activities.

• Domain 7 – Link to/Provide Care

iGrow

iGrow – Coordinated Intake for January December November Total for Home Visiting 2017 2016 2016 Period # CIAT Completed (Coordinated 168 133 108 510 Intake Assessment Tool) # Referred to Partner Home 61 59 51 171 Visiting Programs 10 waitlisted* Board of Health Report January 2017 - Page 16 of 21

*Clients are placed on a wait list when all home visiting programs are at capacity. The Coordinated Intake Worker monitors these clients until they are assigned.

Women’s Health Services/Family Planning

Family Planning Jan 2014 Jan 2015 Jan 2016 Jan 2017 2017 YTD

Number of Clients Seen 397 299 149 161 161 New Clients 84 40 30 21 21 Continuing Clients 313 259 119 140 140 Pregnancy Tests 205 153 82 82 82

Positive Pregnancy Jan-17 Dec-16 Nov-16 Oct-16 Sep-16 Aug-16 Follow Ups

Number of Positive * 13 16 14 6 15 Pregnancies Engaged in Care * 6 8 4 12

Referral to Care * 4 2 1 1 1

Missing / No Return * 1 8 5 2 3 Call WIC 2 5 7 8 5 10 Referred to WIC * 7 1 1 0 3 # of MPE 1 1 1 1 1 1

*Totals will be included in February BOH Report

Illinois Breast and Cervical Cancer Program (IBCCP) The new IBCCP Coordinator, Carissa Hodges, RN, has been working with the temporary coordinator, Carolyn Shelton, to learn the grant program, along with the tools needed to provide the deliverables.

Caseload for FY 2017 is 550 women. As of January 31, 2017, 240 women have been served (44% of caseload). The majority of women enrolled in IBCCP are Hispanic and not eligible for the Affordable Care Act (ACA). Forty-three percent (43%) of screenings have required additional diagnostic follow- up using 53% of the clinical services budget.

Board of Health Report January 2017 - Page 17 of 21

The IBCCP team is working with community partners to increase the percentage of mammograms to women over the age of 50 as 75% of the mammograms must be provided to women in this age group. IBCCP has also received a grant from S.G. Komen for January 1, 2017-December 31, 2017. Funds will be used to pay for approximately 60 screening mammograms for women ages 40 – 49 years. A Silver Lining Foundation also provides mammography services for the 40 – 49 year age group. Case management requires a working knowledge of all the programs to ensure that grant funds are used effectively. There were no women on the Priority wait list for the month of January.

Integrated Clinic Services by Visit Type

WCHD Clinic Visit Type by Month 2016 2017 Visit Type Oct Nov Dec Jan Total Clinician Visit 169 143 146 156 614 Lab Visit 240 Nurse Visit 324 273 325 280 3515 TB/Refugee 83 102 87 74 442 Total 576 518 558 510 6664

Board of Health Report January 2017 - Page 18 of 21

Tuberculosis Care Center Activities

Client(s) Seen New Clients 66 Returning Clients 18

Physician Contacts 22 Medication DOT (direct observed therapy) Visits 30 Diagnostic Servicies X-rays, CT Scan, etc. 37 Screenings Skin Test, T-Spot TB Test 58 Total Active Case(s) in Winnebago County (YTD) 2 Total Actives Case(s) Being Medically Managed 0 Outside of Winnebago County (YTD)

The Tuberculosis Care Center at WCHD continues to provide medical oversight and treatment of two (2) active TB cases in the County at the end of January.

The TB Team continues with client direct observation therapy (DOT) three (3) days a week with one individual. A member of the CD Team, Virginia Lee, is providing translation services as part of the care regimen.

Refugee Health Services Winnebago County Health Department has seen the following number refugees during the current month broken out by gender and year to date (YTD).

2017 YTD 2016 Year 2015 Year Nationality Males Females Total Total Total Afghanistan 0 0 0 10 9 Burma 1 1 2 41 98 Burundi 0 0 0 12 12 Central Africa Republic 0 3 3 16 0 Colombia 0 0 0 0 4 Congo 16 6 22 79 79 Cuba 1 0 1 11 16 Eritrea 4 6 10 14 2 Ethiopia 0 0 0 1 0 Iran 0 0 0 11 4 Iraq 0 0 0 23 51 Ivory Coast 0 0 0 3 0 Rwanda 0 0 0 0 7 Sudan 0 0 0 12 1 Syria 0 0 0 88 35 Board of Health Report January 2017 - Page 19 of 21

Thailand 0 0 0 1 0 Ukraine 0 0 0 5 0 Totals: 38 327 318

• Domain 8 – Assure Competent Workforce

January 2017 Total Full Time Part-Time and Employees New Separated Employees Employees Seasonal Utilizing Hires Employees Employees FMLA 78 76 2 14 2 0

Lisa Sprecher, LEHP completed the necessary prerequisites for advanced training on the FDA Food Code in preparation for implementaiton.

Representatives from the health department and Board members Angie Goral and Bob McCreath attended a community education session sponsored by RAASE (Rockford Alliance Against Sexual Exploitation) on January 11, 2017 on sex trafficking in the Rockford region. This issue impacts substance abuse, violence, family infrastrucuture and crime within the community. An educational session is planned to educate health department staff in recognizing potential victims and intervening.

• Domain 9 – Quality Improvement

The 4 PHAB action plans are being reviewed. Documents are being made to meet each action step. Once the documents are complete, they will be reviewed by the BOH Quality Committee before final submission.

Center projects for 2017 are well underway. Each project will have a final report to submit to the BOH Quality Committee. The Foods Paperless project has been closed. A presentation will be given by QI team lead Lisa Sprecher at the February 2017 BOH meeting.

Performance Management Work continues at the Center/Program level to develop the metrics and action steps to address the Performance Standards.

• Domain 10 – Evidence-based Practices

Substance Abuse Prevention Coalition Covered in sections under coalitions. All Stars and Making Proud Choices curriculum used in Health Promotion is covered under designated sections above.

Board of Health Report January 2017 - Page 20 of 21

Two additional public health nurses have started to work in the Public Health Nursing Programs of APORS (Adverse Pregnancy Outcome Reporting System) High Risk Infant Follow-up and Better Birth Outcomes.

APORS – High January December November October September August Average Risk Infant 2017 2016 2016 2016 2016 2016 Month Follow-up Caseload 112 109 106 115 125 133 117 Referrals 39 57 12 15 44 26 32 Received Referrals 12 9 5 20 22 10 13 Refused Home Visits 38 25 27 27 22 19 26 Completed Office Visits 10 6 10 6 11 10 9 Completed

Better Birth January December November October September August Average Outcomes 2017 2016 2016 2016 2016 2016 Month Caseload 39 45 42 35 31 NA 38 Percent 43% 50% 47% 39% 34% -- 43% Target Caseload = 90

• Domain 11 – Administration and Management

WIC January December November October September August Average 2017 2016 2016 2016 2016 2016 Monthly Caseload Caseload 6319 6274 6315 6617 6673 6667 6478 Goal = 7618 Caseload 83% 82% 83% 87% 88% 88% 85% Achieved Goal = 90%

Chairman Haney toured the Winnebago County Health Department at 555 North Court and was introduced to the staff. He will be scheduled to tour the 401 Division Street in the month of February. Transition meetings have been held with the Chairman and Amanda Hamaker regarding the operational management of North Court.

Board of Health Report January 2017 - Page 21 of 21

• Domain 12 – Governance

T. Marshall and Dr. Martell attended the Operations Committee of the Winnebago County Board on January 30, 2017 to present the amendment to Chapter 50 of the Winnebago County food code which was recommended for approval to advance to the full Winnebago County Board for adoption. The adoption of this amendment will support standardization within the state of Illinois across counties, across neighboring states including Wisconsin and Iowa, establishment of a fee schedule based on risk for foodborne illness. The adoption of the FDA code and new permit fee structure will support consistency among the Food Inspectors and enhance understanding by the community stakeholders.

On January 31, 2017, Dr. Martell served as the moderator for the Orchid (Old Rockford College Historical District) neighborhood mayoral candidate forum. It was an opportunity to ask questions on behalf of the community regarding the social determinants of health - public safety, economic development, education, and mental health.

Respectfully submitted on behalf of the Leadership Team by, Sandra Martell, RN, DNP Public Health Administrator

In observance of Presidents’ Day, the Winnebago County Health Department offices will be closed on Monday, February 20, 2017.