April 2019 Report to the Board of Health

Winnebago County Health Department Leadership Team  Cheryl Floyd, MSEd – Center Director, Health Promotion and Wellness  Cynthia Hall, MPH – Director, Strategic Initiatives  Melinda Idell, RN, MSN – Center Director, Personal Health Services  Theresa James, CHEC III – Center Director, Public Health Preparedness  Todd Kisner, MPH – Center Director, Health Protection  Patrick Madigan, BA – Finance Director  Todd Marshall, BS, LEHP – Center Director, Environmental Health Improvement  Katherine O’Toole, MPH, CPH – Center Director, Communication  Peter Lopatin, MBA – Director, Data and Quality

 Domain I – Monitor Health Environmental Health Improvement (EHI) continues to monitor for critical violations for all EHI programs to identify areas where more education is needed for food operators, contractors, landlords, and the general public.

Indoor Air Monitoring - Month of April 2019 April Fiscal Year April Last Fiscal 2019 to Date Last Year Year to Date Air Quality Inspections Performed 0 10 5 22 CO₂ (PPM) Average 0 798 563 710 Max 0 1461 820 1579 Temperature (F) Average 0 70.5 73.7 70.6 Max 0 78.9 79.5 83 Humidity (%RH) Average 0 38.8 27.6 33.2 Max 0 78.4 49.9 67.5 CO (PPM) Average 0 0.5 0.4 0.5 Max 0 1 0.9 1.5

Homes with at least one reading CO 0 7 0 4 Exceeding guideline: 0 0 0 0 Homes with at least one reading CO₂: 0 1 0 1 Exceeding guideline CO₂: 0 0 0 0 Table 1.0 Board of Health Report April 2019 - Page 2 of 23

Radon Winnebago County Health Department (WCHD) sold more than 30 radon test kits during the Radon Contest period. A total of six (6) test results were at or above the EPA recommended action level and qualify for entry into the drawing. WCHD staff continue to promote radon awareness and the test kits at outreach events. Fiscal Year April Last Fiscal Year April 2019 to Date Year to Date Radon Screenings 0 15 2 22 Average (pCi/L) 0 3.7 11.3 4.5 Max (pCi/L) 0 11.9 15.3 15.3 Radon Test Kits Purchased 10 56 1 22 Average (pCi/L) 5.5 4.3 - 5.7 Max (pCi/L) 10.3 10.9 - 17 Phone Calls 5 41 8 45 Units Reported as mitigated 0 1 0 7 Table 1.1

Vector Surveillance (West Nile Virus) WCHD held its annual larvicide training on April 19, 2019 for WCHD staff and other municipal public works staff. Due to the Good Friday holiday, not all municipalities were able to be represented. WCHD will host a 2nd training session in the near future so all municipalities have the opportunity to apply larvicide.

WCHD obtained supplies and inventoried all equipment to prepare for placing mosquito traps. Staff have made the “mosquito soup” and will begin surveillance activities in early May. WCHD also participated in an interview with WREX regarding the upcoming mosquito season. WCHD sent out a press release regarding the “3 R’s” and promoting the involvement of neighborhood “Mosquito Captains.”

The Illinois Youth Survey (IYS) Outreach will continue with the superintendents about the importance of monitoring current trends in youth substance abuse, violence, school experiences and climate, and mental, social, and physical health. Substance Abuse Prevention Specialists (SAPS) will meet in June with each Superintendent or identified School District personnel to discuss current substance abuse prevention and student health services in the school district and identify potential dates for the IYS 2020 survey.

Retail Licensing for Tobacco & Nicotine Products The Standardized Tobacco Assessment for Retail Settings (STARS) assessments will be continued through June 30, 2019. STARS is a tool to gather information among tobacco retailers including electronic delivery systems or E cigarettes. Results will provide information on product, placement Board of Health Report April 2019 - Page 3 of 23

of advertisement and product in the store, and price of product. Results will be used to promote development and evaluation of local tobacco control ordinances within each municipality.

Restricting Indoor E-cigarette Use The Tobacco Control Specialist has been gathering data on current municipality ordinances outside Winnebago County that have implemented a restriction on indoor e-cigarette use. A survey of local businesses in Winnebago County will be conducted regarding their current e-cigarette policy. Information will be compiled and provided to local stakeholders when preparing for policy/ordinance changes.

 Domain 2 – Diagnose and Investigate

Creating a Lead Safe Rockford (CLSR) 2016 Objectives Creating a Lead Safe Rockford (CLSR) staff continue to have difficulties with the results of Historic Reviews for properties enrolled in the program. Increasing wait times and an increasing number of homes being deemed historic have resulted in more homes being denied (for being over budget) or dropping out of the program. WCHD Administration has reached out to other communities who are having similar issues, as well as to Illinois Department of Public Health (IDPH) Environmental Health (EH) Division Chief to assist with communicating these concerns to the Department Head for the Historic Preservation Agency.

Goal Actual Percent Units Enrolled 175 153 87% Inspections 165 146 88% Mitigated Units 150 112 75% Table 2.0

Testing Lead in Water April FY 2019 Samples Taken & Analyzed 5 20 Number Exceeding EPA/IL Lead Hazard Level 0 0 Average Lead Content 2.4 2.3 Maximum Lead Content 5 5 Table 2.1

Food Complaints April FY 2019 Last Fiscal YTD # of Foodborne Illness Complaints 3 13 17 # of Foodborne Illness Investigations 3 13 17 # of Non-foodborne Illness Complaints 15 107 112 Table 2.2

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Housing Complaints April FY 2019 Last Fiscal YTD # of Housing Complaints 66 373 454 # of Nuisance Complaints 50 165 148 # of Survey Complaints 30 299 210 # of Received Complaints 160 920 882 # of Re-check on Complaints 648 3967 2736 Table 2.3

Wells & Septic Complaints April April FY19 FY19 FY18 FY18 Original Recheck Original Recheck Original Recheck Complaints Complaints Complaints Complaints Complaints Complaints Wells 2 2 12 23 8 6 Septic 7 6 18 38 14 5 Table 2.4

Communicable Diseases Reported in Winnebago County 2019 YTD Vaccine Preventable April Investigated & 2018 Year 2017 Year 2019 YTD 2019 Determined Total Total Diseases Cases * (Reporting timeframe) Cases "Not a Case" Cases Cases ** Chickenpox (Varicella) (24h) 1 4 5 4 4 Diphtheria (immediate) 0 0 0 0 0 Haemophilus influenzae, invasive (24h) 1 3 2 8 9 Hepatitis A (24h) 0 3 0 2 1 Hepatitis B-Acute Infection (7d) 0 1 0 1 1 Hepatitis B-Chronic (7d) 0 18 2 24 39 Hepatitis D (7d) 0 0 0 0 0 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) 2 3 25 64 36 Measles (rubeola) (24h) 0 3 0 0 0 Mumps (24h) 0 1 0 0 1 Neisseria meningitidis, invasive (24h) 0 0 0 1 0 Pertussis (whooping cough) (24h) 0 1 5 18 38 Poliomyelitis (immediate) 0 0 0 0 0 Rubella (24h) 0 0 0 0 0 S. pneumoniae - non-drug resistant invasive disease (<5yrs) 0 0 0 1 3 Board of Health Report April 2019 - Page 5 of 23

Tetanus (7d) 0 0 0 0 0 Sexually Transmitted Infections AIDS (7d) 0 0 0 7 12 Chancroid (7d) 0 0 0 0 0 Chlamydia (7d) 174 17 763 2108 1980 Gonorrhea (7d) 65 6 247 743 659 HIV infection (7d) 2 0 3 27 21 Syphilis (7d) 7 0 11 14 15 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 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) 3 0 15 88 70 Chikungunya Non-neuroinvasive Disease (7d) 0 0 0 0 0 Chikungunya Neuroinvasive Disease (7d) 0 0 0 0 0 Cholera (24h) 0 0 0 0 0 Cryptosporidiosis (7d) 0 0 6 21 22 Cyclosporiasis (7d) 0 0 0 13 3 Dengue (7d) 0 0 0 0 0 Ehrlichiosis (7d) 0 0 0 0 0 Enteric E. coli infections (STEC,O157:H7) (24h) 1 0 7 29 12 Foodborne or waterborne outbreaks (24h) 0 0 0 0 0 Hantavirus pulmonary syndrome (24h) 0 0 0 0 0 Board of Health Report April 2019 - Page 6 of 23

Hemolytic uremic syndrome, post diarrheal (24h) 0 0 0 0 0 Hepatitis C-Acute (7d) 0 0 0 7 1 Hepatitis C-Chronic (7d) 10 400 49 200 198 Histoplasmosis (7d) 0 2 0 2 5 Legionellosis (7d) 0 0 2 11 9 Leptospirosis (7d) 0 0 0 0 0 Listeriosis (7d) 0 0 0 1 0 Lyme disease (7d) 1 6 2 10 6 Malaria (7d) 0 0 0 0 0 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, animal case (24h) 0 0 1 1 1 Rabies, human case (24h) 0 0 0 0 0 Rabies, potential human exposure (24h) 1 0 6 36 19 Reye syndrome (7d) 0 0 0 0 0 Salmonellosis, other than typhoid (7d) 1 1 3 68 44 Severe Acute Respiratory Syndrome (SARS) (immediate) 0 0 0 0 0 Shigellosis (7d) 0 0 3 9 3 Smallpox (immediate) 0 0 0 0 0 Smallpox vaccination, complications of (24h) 0 0 0 0 0 Spotted fever rickettsioses (7d) 0 0 0 0 1 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 0 5 13 10 Toxic shock syndrome due to S. aureus (7d) 0 0 0 0 0 Trichinosis (7d) 0 0 0 0 0 Tuberculosis (7d) 0 0 1 1 3 Board of Health Report April 2019 - Page 7 of 23

Tularemia (24h unless bioterrorism suspected then immediate) 0 0 0 0 0 Typhoid fever (24h) 0 0 0 1 1 Typhus (24h) 0 0 0 0 0 Vibriosis (non cholera) (7d) 0 0 1 6 4 West Nile Fever (7d) 0 2 0 1 3 Zika Virus 0 1 0 0 0

* The above table represents the diseases reported this month and year to date in comparison to the previous two year totals. Note: All data are preliminary and may change as more reports are received. ** “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 Influenza Surveillance: On April 17, 2019, the CD Team issued a Health Alert based on the surveillance activity, to discontinue (or lift) the enhanced Infection Control Practices for influenza, including visitor restrictions and masking of unvaccinated health care workers.

The CD Team continues to conduct influenza surveillance with our health care partners. As part of the surveillance activities, the Team publishes the weekly Influenza Surveillance Report, sends it to our partners through email, and it is located on the WCHD website. For the CDC Week 18, which ended on March 4, a total of 3,101 cases of influenza have been reported as noted in the graph below.

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Candida auris: On April 12, 2019, the CD Team issued a Health Alert on Candida auris Prevention and Reporting Recommendations. Candida auris (C. auris) is an emerging fungus of growing public health concern. C. auris can cause outbreaks in healthcare and long-term care facilities. The fungus is difficult to identify with standard laboratory techniques and treatment can be challenging due to its resistance to medications commonly used to treat fungal infections. As of February 28, 2019, the Centers for Disease Control and Prevention (CDC) reported 587 confirmed cases in the United States with 144 confirmed and 4 probable cases in Illinois. Currently, no cases of C. auris have been reported in Winnebago County.

 Domain 3 – Inform, Educate, and Empower

“Protecting Your Sexual Health” Presentations in the Community The Communicable Disease (CD) Team delivered their new sexual health presentation to local agencies/educational institutions to provide education on sexually transmitted infections (STI). The presentation includes the signs/symptoms of an STI, the importance of seeking treatment and ways to prevent getting an infection. In addition, participants learned about the Ryan White Program for persons living with HIV and the services available to them. Each participant received an informational pamphlet on STI facts to take with them for reference in the future.

The presentations occurred on: • April 16, 2019 - Virginia Lee and Trish Paesani provided a presentation to 90 young adults (ages ranging 14-18 years) at Rosecrance Griffin Williamson Campus, a substance abuse treatment facility. • April 26, 2019 - Virginia Lee and Trish Paesani provided a presentation to 18 young adults (ages ranging 16-24 years) at Youth Build, an innovative youth community development program.

Neighborhood Property Standards Update With recent public attention toward garbage/landfill/waste hauler issues, WCHD staff have begun looking into revising and modernizing the County’s Waste Hauler code. This may include clearer definitions of waste haulers and activities, strengthening responsibilities, provisions for monitoring and enforcement, and potential fee increases.

Tobacco Free Communities Quitline Referral Partners: There were two referrals for the month of April. The Tobacco Control Prevention Specialist will begin working with a small committee from the Winnebago County Substance Abuse Prevention Coalition to develop an outreach plan to connect with potential partners including the healthcare systems and other organizations that focus on healthy pre- and post-partum women. Board of Health Report April 2019 - Page 9 of 23

Electronic and Social Media Stats

April 2019 WCHD Website Page 11.9K Pages Views 4.1K Sessions 3.1K Users Facebook 410 Avg. Weekly Reach 133 Weekly Engagements 953 Total Likes Twitter 6K Tweet Impressions 0 New Likes 11 Total Likes 842 Followers Intranet Page 0 Page Views 0 Sessions 0 Users Table 3.1

National Prevention Week National Prevention Week, sponsored by Substance Abuse and Mental Health Services Administration (SAMHSA), will occur May 12-18, 2019. The Youth Leadership Council (YLC) developed two awareness tools on Underage Drinking Prevention and Opioid/Prescription Drug Misuse and will use them during Prevention Week. The YLC will promote the week activities within their home communities. The YLC has agreed to attend the Love Rockford community event, May 11, 2019, and provide educational materials about prescription drug misuse and local resources available to help individuals find help for family or friends. The YLC students will decorate the health department’s medication drop off box to create awareness about safe disposal of unused or expired medications. YLC students will paint the “Take It To the Box” on Saturday, May 18, 2019.

 Domain 4 – Mobilize Community Partnerships

Trauma Informed Community The Film Series Workgroup is planning their next series to begin in June and is looking to host in Loves Park/Machesney Park as the original group of films were shown in Rockford. Harlem School District is a potential site.

In recognition of the State of Illinois’ Trauma Informed Awareness Day, the Public Awareness Workgroup is hosting an event on May 15. There will be a recognition ceremony for workgroup members and early adopters of the Trauma Informed Proclamation followed by a Trauma 101 Training. The event will be held at Patriot’s Gateway on May 15 from 4:00 – 5:30.

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Winnebago County Substance Abuse Prevention Coalition (WCSAPC) The coalition will increase its focus to alcohol, tobacco, and other drug prevention. New coalition members will be invited to participate from school and community partnerships to represent specific stakeholders within Winnebago County. WCSAPC will also network with other local and regional coalitions focusing on substance abuse prevention including the Winnebago County Opioid Task Force and Drug Overdose Prevention Program (DOPP) partnership and the substance abuse coalitions in Boone and McHenry Counties.

Substance Abuse Prevention Awareness Campaigns Underage Drinking Parent Awareness: The underage drinking awareness campaign for parents of 900 Harlem Middle School students was completed in April. Substance Abuse Prevention Specialists (SAPS) met with the Harlem Middle School principal to discuss future awareness campaigns and identify new opportunities to help create awareness for parents. The SAPS distributed 6,255 pieces of literature throughout the school-year campaign. Campaign materials were mailed to each middle school student’s home.

Chairman and Mayor’s Youth Leadership Council On April 6, 2019, over 50 students from various Rockford and Winnebago County Schools attended the first Chairman and Mayor’s Youth Leadership Council Town Hall Meeting at Rockford University. Students were informed of the event through the Chairman’ office, Mayor’s office, personal invites from the Youth Leadership Council (YLC) students, and social media. The YLC students were pleased with the attendance. The participant surveys indicated the students found the event to be a good opportunity to hear about local initiatives and to learn how young people can become more involved in their community. YLC would like to provide another town hall meeting next year.

YLC members assisted in the selection of promotional materials for National Prevention Week and continue to develop ideas to promote and implement the One Love violence prevention youth awareness program in selected pilot schools for school year 2019-2020.

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DOPP (Drug Overdose Prevention Program) Community Partnerships

 The Drug Overdose Prevention Specialist (DOPP) Partnership continues to meet monthly to discuss training updates, review current data on overdose calls and area “hot spots”, and discuss outreach opportunities and strategies.  Highlighted trainings: UIC College of Pharmacy, Kinnikinnick School, YouthBuild, SwedishAmerican Clinic Managers, SwedishAmerican Hospital Emergency Department Charge Nurses, Remedies, and WCHD Open House.  SwedishAmerican Hospital’s Emergency Department Charge Nurses participated in a “train the trainer” class in preparation for the Emergency Department to begin providing Narcan trainings to individuals brought in for an overdose and families of those patients.  SwedishAmerican’s Clinic Managers received training and expressed interest in having their individual clinic staff trained. The DOPP Specialist, Mobile Integrated Health Manager with the Rockford Fire Department, and Cat Lewis of SwedishAmerican will be working on scheduling clinic trainings throughout the coming months.  The DOPP Specialist trained 16 walk-in individuals during WCHD’s Open House.  1 overdose reversal form was received during the month of April.  896 community members have received Narcan training in FY19.

DOPP Community Outreach # Training # NARCAN # Reversal DOPP Community # Training Sessions Kits Provided Forms Outreach Participants Provided at Trainings Received July 6 40 35 1 August 12 89 84 1 September 13 69 66 0 October 23 99 96 0 November 10 23 25 2 December 15 114 96 0 January 12 92 89 1 February 18 124 124 0 March 16 117 121 0 April 27 129 131 1

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Guard and Discard: The Guard and Discard Campaign raises awareness about the importance of safe storage and proper disposal of prescription medications. Participating organizations in which materials were distributed include: the Retired Senior Volunteer Program (RSVP), Rosecrance, Mercyhealth, SwedishAmerican, Liberty Baptist Church Health Fair, UPS Health fair, and Oak Street Health.

National DEA Drug Take Back Day Substance Abuse Professionals have created social media messages for local media to assist in promoting the spring event on April 27, 2019. Loves Park Police Department participated through a partnership with Walgreens on North Alpine, Loves Park. A local radio station, WYBR Power 106, utilized the DEA PSA announcement provided by WCHD SAPS to provide free announcements prior to the Saturday event. WHCD sent social media messages and created interest for clinic clients at WCHD with brief information about the day and where to dispose of medications.

TEEX Class “Strategic Overview of Disaster Management for Water and Waste Water Utilities” workshop was held at Winnebago County Health Ddepartment on Thursday, April 18, 2019. This workshop was presented by Texas A&M Extension Office out of College Station, Texas. Thirty-one people attended this workshop which included jurisdiction officials and heads of water and water treatment facilities. This workshop provides critical guidance when planning for and responding to disasters that affect drinking water and wastewater systems. Participants will be introduced to the various natural and man-made (accidental or intentional) disasters to which water and wastewater systems may be vulnerable and the potential effects of disasters. Case studies on a variety of disaster incidents, as well as hypothetical situations for water and wastewater incidents were examined.

 Domain 5 – Policies and Plans

Strategic Initiatives Policy Makers, Workforce Development, Assessors and Reporters workgroups are collaborating on a mental health assessment, training and policy for WCHD.

The Collaborators and Organizers workgroups are assisting in the IPLAN 2025.

The Re-accreditation and Assurance workgroups continue to work on their data collection and documentation.

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Active Shooter Exercise On Wedensday, April 17, 2019, Winnebago County Health Department Preparedness Center asisted with the development and exercise of the Rock Valley College Active Shooter Functional Scale Exercise. The planning that is going into this exercise, is a 3 Phase process which will culminate into a Mass Casualty, Mass Surge Full Scale Exercise in the Fall of 2020.

 This first phase functional was to work out the commnications piece and regional response.  The second phase functional is planned for fall of 2019 and includes triage, set up of triage, Medical reserve Corps Volunteer and spontaneous response, and movement of wounded at a local and regional level.  The third phase will be bringing it all together from day 1 including movement of patients to hospitals and MRC triage set up points. Rock Valley College has been intrumental in the planning and exercise of the Winnebago County Health Department Full Scale Active Shooter Bi-Annual trainings.

 Domain 6 – Enforce Laws

EHI Code Enforcement Stats April FY 2019 FY 2018 (YTD)

Inspections Inspections Inspections Foods 347 2140 1915 Liquor Inspections 95 385 439 Wells 4 60 75 Septic 4 47 47 Loan Inspection 21 175 254 Table 6.0

In-House Administrative In-House FY 2018 FY 2018 Administrative Hearings Hearings Hearing Administrative In-House Hearings April April (FY19) (FY2019) Hearings Hearings Housing 38 47 189 261 93 159 Foods 0 0 0 2 0 10 Well/Septic 0 3 0 3 2 6 Table 6.1

Report of food facility in-house hearings No hearings for the month of April 2019

Illinois Tobacco Free Communities/Smoke Free Illinois Act (SFIA) There were a total of 8 compliance checks completed for the month of April with verbal complaints of 7 local food pantries and areas located by their entrances in which food pantry participants wait to get into the food pantry and 1 complaint received for a historical non-complaint business in the month of Board of Health Report April 2019 - Page 14 of 23

April. Signage was provided for the 7 local food pantries to help reduce secondhand smoke exposure while participants are waiting in line.

 Current businesses working to ensure compliance: None

Random Smoke Free Illinois External Internal Checks: Citation Hearing Compliance Enforcement: Referrals Referrals Outreach Targeted Issued April Efforts Checks Non Food Establishments 1 0 0 1 0 0 Alcohol Establishments 0 0 0 0 0 0 Food Establishments 7 0 0 7 0 0 Month Total 8 0 0 8 0 0 FY19 Total 32 6 240 39 2 1 Table 6.3

Tobacco Enforcement Program (TEP) WCHD, in partnership with the City of Rockford Police Department, City of South Beloit Police Department, and the Village of Roscoe Police Department, coordinates and conducts underage tobacco compliance checks. The final round of tobacco checks for FY 2019 is set for May. A new proposal was submitted to DHS for FY20. The same police departments have agreed to participate again in the WCHD application. Loves Park Police Department decided to continue efforts for their community by submitting their own grant application.

 Domain 7 – Link to/Provide Care iGrow Trena Graceffa filled the Coordinated Intake Worker position on April 15, 2019. Trena returns to WCHD after a 4-year absence. She had been working as a home visitor for a partner agency (Rockford Public School District #205) prior to returning to the health department. She has a great understanding of the iGrow Programs.

iGrow - Coordinated Intake for Home Visiting January February March April # CIAT Completed (Coordinated Intake Assessment Tool) 75 101 66 66 # Referred to Partner Home Visiting Programs 70 101 66 66 # Referred to Outside Home Visiting Agencies 5 0 0 0 # Currently Receiving Home Visiting Services 0 0 0 0 Table 7.0

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Family Planning Calendar Year 2019 Family Planning April YTD Number of Clients Seen 210 399 New Clients 62 58 Continuing Clients 148 330 Pregnancy Tests 65 144 Table 7.1

Calendar Year Family Planning Quality Measures April 2019 YTD Number of Initial Visits 25 64 Number Charts Reviewed 10 30 Number with ACES Screen 10 30 Number with Pre/Interconception 10 30 Education Documented ACES Compliance 100% 100% PRE/Interconception Compliance 100% 100% Table 7.1B

Dental Sealant Grant # Dental Sealants # Dental Sealants # Students Served # Students Provided with Provided with with Dental Served with Month Dental Sealant Dental Sealant Sealant Grant Dental Sealant Grant 2018 Grant 2019 2018 Grant 2019 September 77 44 16 9 October 96 331 21 97 November 124 262 20 66 December 51 357 8 76 January 71 176 16 51 February 97 190 22 45 March 156 249 38 58 April 277 448 101 84 Total 949 2057 242 486 Table 7.3

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Illinois Breast & Cervical Cancer Program (IBCCP) Clients Served by Age Under 35 35-39 40-49 Over 50 New Clients 1 1 4 1 Grant Year To Date New Clients 7 12 45 27 Total Enrollment 8 7 29 6 Grant Year Total Enrollment 33 55 273 74 Table 7.4

Services Provided Under 35 35-39 40-49 Over 50 Clinical Breast Exam 5 2 7 5 Grant Year Clinical Breast Exam 10 11 151 98 Mammograms 0 0 20 6 Grant Year Mammograms 0 1 150 89 Pap Smear 1 2 3 1 Grant Year Pap Smear 3 9 35 27 Table 7.5

Grant Year Expected Caseload Actual % 550 435 79% Table 7.6

Integrated Clinic Clinician Clinician Nurse Visit Nurse Visit

Visit CY 2019 Visit CY 2018 CY 2019 CY 2018 February 161 137 233 245 March 187 191 213 220 April 213 97 222 158 3 month Total 5610 425 668 623 Table 7.7

WCHD Clinic Visit Type by Month Visit Type October November December January February March April Clinic Visit 193 143 164 187 161 187 213 Nurse Visit 335 289 252 220 233 213 222 TB/Refugee 10 20 9 5 11 7 6 Total 538 452 425 412 405 407 441 Table 7.8

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Refugee Health April Calendar Year 2019 2018 Nationality Male Female Month YTD Total Afghanistan Burma Burundi 17 Central Afr. Rep. Congo 3 4 7 21 89 Cuba 1 Eritrea Ethiopia Iran Iraq 3 Ivory Coast 1 Pakistan 3 Rwanda 4 Sudan Syria 1 Tanzania 2 Thailand 6 Ukraine Vietnam Totals: 7 21 127 Table 7.9

Tuberculosis (TB) Activities Clients Seen April Count YTD New Clients 17 21 Returning Clients 6 27 Total Encounters 25 47 Physician Contact 16 13 Medication (Direct Observation Therapy Visit) 28 134 Diagnostic Testing X-rays, CT Scans, etc. 23 37 Screenings TB Skin Test, T-Spot Test 4 9 Positive TB Skin Test/T-Spot 2 5 Total Active Cases in Winnebago County (YTD) 2 Total Active Cases being Medically Managed Outside of Winnebago County (YTD) 1 2 Table 7.10

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Women, Infants, and Children Supplemental Nutrition Program (WIC)  WIC caseload for April was 6,146 - 93% of caseload.  The three (3) month breastfeeding exclusivity rate for March was 6.1%. The state has not yet released April breastfeeding exclusivity rates.  Katie and Taylor had meaningful breastfeeding contacts with 76 of 100 (76%) pregnant WIC mothers due within 30 days.  Tasha Trauth, the new WIC Clerk, started on April 1st.  On April 5th, WIC staff attended a day long breastfeeding training entitled “Navigating Breastfeeding Challenges: Hop on the Train”, presented by Nancy Mohrbacher, IBCLC, FILCA. Topics discussed included strategies to reduce early feeding problems, navigating breastfeeding trainwrecks, breastfeeding and substance use/abuse and breastfeeding in the digital age. Topics were very timely and interesting; staff feedback was very positive. The WIC Staff are grateful for the opportunity and would like to thank WCHD leadership for allowing all WIC staff to attend this worthwhile breastfeeding conference.  Donna and Tasha attended a WIC Nutrition Assessment and Risk Factor Training on April 12th in DeKalb. This is a new refresher course developed by the Community Health Training Center to ensure assessments, assigned nutrition risk factors, appropriate nutrition education and referrals are conducted accurately as required by the WIC Program.  The WIC Symposium was held in Springfield on April 23rd and 24th. Discussions included EBT/MIS implementation (should be completed by 5/20), risk factor updates, outreach strategies, WIC food/nutrient education and the birth to three initiatives. The Winnebago County WIC Program was recognized for meeting 93% caseload grant deliverables for FY19.  In my absence, Katie attended the quarterly WIC Coordinator’s meeting on 4/26/19 in DeKalb. The current MEQA Tool and NEP were reviewed. They also played a breastfeeding Jeopardy game which will be shared with Coordinators to use at staff meetings.  WIC participated in several outreach events this month. Katie and Taylor completed a WIC presentation for an early childhood education class at Rock Valley College on 4/2/19. April represented WIC at the Week of the Young Child Fair the morning of April 6th and Leia participated in the VanMatre employee wellness fair on April 25th.

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WIC Avg Per April March February January December November Month FY 19 Caseload Goal = 6613 6149 6079 5966 5995 6102 6190 6080 Caseload Achieved Goal = 90% 93% 92% 90% 90% 92% 94% 92% Table 7.11 FY19 caseload is 6613

 Domain 8 – Assure Competent Workforce April 2019 Total Full Time Part-Time Part-Time and Employees New Separated Employees Employees Employees Seasonal Employees Utilizing FMLA Hires Employees 91 88 2 0 9 5 1 Table 8.0

Service awards were presented to Winnebago County Health Department Staff as part of the annual recognition of Winnebago County employees. Congratulations and thanks to our staff who were honored:  Carmelo Porta Gonzalez (Environmental Health Improvement/Lead) – 5 years  Lesley Wallace (Environmental Health Improvement/Lead) – 5 years  Jeannie Alonzo (Personal Health Services/HealthWorks) – 15 years  Tracy Box-Netters (Health Protection/Ryan White Case Management) – 15 years  Todd Kisner (Health Protection/Center Director) – 15 years

 Domain 9 – Quality Improvement All of the 2018 Quality Improvement Initiative Storyboards were on display to inform the public on the work that was done and the organization’s commitment to continuous quality improvement. The storyboards will be on display throughout the department and rotated throughout the year so that staff can appreciate the work that is being done by their colleagues in other programs/Centers. Work continues on the 2019 Quality Improvement Initiatives.

 Domain 10 - Evidenced Based Practice Dr. Martell moderated a panel at the annual University of Illinois College of Medicine at, Rockford Research Day held on April 30, 2019. The panel focused on research addressing health disparities through health equity.

Winnebago County Health Department Staff Angel Abraham, MPH; Ryan Kerch, LEHP; Todd Kisner, MPH; and Gerrica Sallis-Smith, MPH reviewed and judged the research projects focused on community/public health on April 29, 2019 to select the project that advanced the practice of Board of Health Report April 2019 - Page 20 of 23

public health. Corey Hazekamp was selected for the Public Health Award for his research on the correlation of eviction to identified health conditions in Rockford. His focus on housing the social determinant of health provides consideration for policies that support access to quality, affordable housing. It is also indicative of potential trauma and its impact on health in the community.

Substance Abuse Youth Prevention Education (YPE) The SAP Specialist completed the All Stars Booster sessions for RESA Middle School during the month of April. Barbour Middle School has agreed to continue All Stars for the 2019-2020 school year.

Below is a summary of the number of students who participated in All Stars:

Total YPE for Spring 2018 Schools- Spring Grade Curriculum Number of students 2019 participated RESA- Spring 8th Grade Booster- 9 Sessions 148

My Generation RX My Generation RX is a “mid-year” initiative through the Substance Abuse Prevention Program (SAPP) grant that will take place during the months of May and June. WCHD will utilize UIC College of Pharmacy students to facilitate the curriculum for a minimum of 250 youth. Substance Abuse Prevention Specialists (SAPS) are contacting local summer camp programs, summer school programs, and other youth organizations to schedule the program for youth participants. Currently, Rockford Park District sites, Pecatonica Middle School, Blackhawk Area Council Eagle Scouts, and the YMCA Achievers Club have agreed to provide the program for their youth members.

APORS APORS - High Avg per Risk Infant April March February January December November Month Follow-up Caseload 133 128 130 126 126 120 124 Referrals Received 22 21 22 34 34 51 34 Referrals Refused 4 3 2 9 5 9 7 Home Visiting Completed 40 39 40 49 48 56 47 Office Visits Completed 7 4 2 6 8 5 6 Table 10.0

Board of Health Report April 2019 - Page 21 of 23

Better Birth Outcomes-High Risk Prenatal Case Management

Better Birth Outcomes April Caseload 82 % of Target Caseload n= 80 103% Table 10.1

HealthWorks Case Load April Current Caseload Winnebago County 209 Current Caseload Border Counties 228 New Cases to DCFS Custody 60 Case Closure Winnebago County 41 Table 10.2

 Domain 11 – Administration and Management

James (Jim) Keeler started as the Director of Finance on April 1, 2019 and is working through transition and orientation with the current Director of Finance, Pat Madigan who will be retiring. Dr. Martell met with States Attorney Marilyn Hite-Ross and Chief of Civil Division David Kurlinkus to review the role of the States Attorney with the Winnebago County Health Department. They will be working to provide coverage until new staff is hired to assist with the health department.

Open House Celebration On April 4, 2019, the Winnebago County Health Department (WCHD) welcomed partner agencies and community members to our Open House Celebration to recognize Public Health Week and commemorate the new WCHD logo. Over 40 participants joined in the celebration by touring the health department, taking trainings on trauma 101 and Narcan, and helping WCHD Dr. Martell commemorates the new WCHD logo commemorate the new logo. and discusses WCHD’s strategies for reaching

our vision of healthy people in a healthy community without health disparities.

WCHD Staff talks with participants and demonstrates environmental health tools. Board of Health Report April 2019 - Page 22 of 23

WCHD Staff Emily Schmidt provides Narcan Training to over 16 participants.

WCHD Staff Karen Hobbs & Cheryl Floyd read to children during story time. Additional kids’ activities included handwashing and coloring.

WCHD Staff Rebecca Ramsey talks about the Center for Health Protection with tour participants

WCHD is grateful to all those who could participate to help us recognize the important work of public health!

NIPARCH Virtual Surge Drill Also on Wednesday, April 17, 2019, the Regional Hospital Coordinating Center (RHCC) held a virtual surge drill that Winnebago County Health Department responded to throughout the day.

 Domain 12 – Governance In response to community concerns on waste haulers and the landfill, Dr. Martell and Todd Marshall prepared strategies to address the concerns and issues for the Winnebago County Board. The ordinances are in the process of review for consideration by the Winnebago County Board of Health and the Winnebago County Board.

Board of Health Report April 2019 - Page 23 of 23

Regular meetings were held with the Mayor McNamara and Chairman Haney regarding public health issues and concerns in the community.

Dr. Martell presented to the Rockford City Council on the efforts of the Winnebago County Opioid Response Team (formerly the Opioid Task Force) with co-lead Chief Derek Bergsten on April 29, 2019.

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