Report to the Board of Health – January 2016

Winnebago County Health Department Leadership Team • Kyle Auman – Health Equity Coordinator • Sue Fuller – Public Information Officer • Lisa Gonzalez, MPH – Center Director, Family Health Services • Theresa James – Emergency Response Coordinator • Todd Kisner, MPH – Interim Center Director Health Protection and Promotion • Todd Marshall, LEHP – Center Director, Environmental Health Improvement • Patrick Madigan – Finance Director • 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. Over the holidays, Environmental Health published several educational press releases through social media reminding the public the importance of food safety and handwashing.

Indoor Air Monitoring

# of CO2 Temp Humidity CO Units Month Average 3 969 69.5 33.2 0.9 Month Max 3 2130 77.8 44.0 1.0 YTD Overall Avg 50 969 ppm 69.5 33.2 0.9 ppm YTD Overall Max 50 2130 ppm 77.8 F 44.0% 1 ppm

CO2 CO YTD-CO2 YTD-CO IDPH Guideline (ppm) > 1,000 > 9.0 > 1,000 > 9.0 with at least one reading exceeding guideline 2 0 2 0 % of Homes Monitored 66.7% 0.0% 66.7% 0.0% Homes whose overall average exceeds guideline 1 0 1 0 % of Homes Monitored 33.3% 0.0% 33.3% 0.0%

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Radon

Phone Number of Radon Average Max Number of Calls Units Screenings (pCi/L) (pCi/L) Mitigation Month 27 7 7 1.4 3.2 1 FY16 to Date 27 7 7 1.4 3.2 1 Program total 68 30 30 4.2 14.0 8

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.

January was National Radon Awareness Month. To help educate the public about the risks of radon and to promote use of the radon screening tools, the WCHD’s social media accounts pushed out several radon-related messages to its subscribers. Staff were also interviewed and were featured on local television news to promote radon awareness. As a result of these efforts, interest in the screening tools increased significantly. In January, six (6) households utilized the equipment and our waitlist increased to approximately 20 additional households.

West Nile Virus Surveillance WCHD has finished its 2016 application for funding from the State for its West Nile/Vector Control grant. The amount allocated for Winnebago County was approximately $34,000—a significant decrease from the $51,489 awarded in 2015. To offset this reduction, the WCHD is planning to utilize up to 40% of an existing staff member’s time for the West Nile Season, rather than hire an additional staff member for the season. All program activities will continue in 2016, however decreased staff time will result in fewer dead bird pickups, less larviciding, and fewer outreach events. Communities will be notified of the changes to assist them with their planning larviciding. The amount of WNV surveillance traps and testing should remain relatively consistent.

Sexually Transmitted Infections

STI Diagnosed in 2015 Year Total 2014 Year Total YTD 2016 WCHD Clinic Cases Cases Syphilis 0 9 5

Gonorrhea 8 75 117

HPV 1 44 111

Chlamydia 21 197 339

HIV 0 2 0

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Illinois Youth Survey ATOD (Alcohol , and Other Drug) specialist has contacted all schools in Winnebago County to advocate for registering for the IYS survey which can be completed by May, 2016. Currently only 5 schools are registered to do the survey. The Health Promotion (HP) Intern will work with ATOD specialist to contact school counselors and Principals via telephone to determine if they would be able to schedule a testing day with 8th, 10th and 12th graders advocating for the schools to complete the survey which can provide valuable information for their school and the county in determining drug perceptions and usage trends and provide documentation of program planning.

• Domain 2 – Diagnose and Investigate

CLSR (Creating Lead Safe Rockford) 2013 Objectives Note

Goal Actual Percent Units Enrolled 300 148 49.3 % Inspections 250 140 56.0 % Mitigated Units 225 98 43.6 %

The CLSR 2013 program is entering its last year, and is currently focused on enrolling as many eligible homes as possible. The program has many outreach events on its calendar and will continue to promote the program through existing contacts. CLSR program staff are anticipating HUD’s Notice of Funding Availability and are ready to begin the application process once it’s released. A successful application would allow the CLSR program to continue with little to no gap in service to the community. One (1) staff member has successfully completed the examination for Healthy Homes Specialist certification, and one (1) additional staff member is scheduled to complete it in February. These certifications help the CLSR and WCHD Neighborhoods programs work together more collaboratively and will make WCHD programs more competitive in the upcoming grant applications.

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Food Complaints

Month FY 2016 FY 2015 # of Foodborne Illness Complaints 1 11 10 # of Foodborne Illness Investigations 1 11 10 # of Non-foodborne Illness Complaints 9 39 46

Housing Complaints

Month FY 2016 FY 2015 # of Housing Complaints 63 222 213 # of Nuisance Complaints 6 35 45 # of Survey Complaints 23 146 187 # of Received Complaints 99 416 493 # of Re-check on Complaints 302 1348 1495

The Neighborhood Code Enforcement program continues working with the State’s Attorney’s office to adopt the 2015 International Property Maintenance Code. The program is also preparing to have an in-person meeting with the City of Rockford’s Neighborhood and Property Standards programs to coordinate enforcement activities so that differences between codes and duplication of services are eliminated.

Well and Septic Complaints

Original Recheck FY16 FY16 Recheck FY15 Original FY15 Recheck complaints complaints Original complaints complaints complaints complaints Wells 2 1 8 8 2 3 Septic 0 0 8 5 1 5

Communicable Diseases

2016 YTD January 2016 YTD 2015 Year 2014 Year Vaccine Preventable Investigated 2016 Total Total Total & Diseases Confirmed Confirmed Confirmed Confirmed Determined (Reporting timeframe) Cases Cases Cases Cases "Not a Case" Chickenpox (Varicella) (24h) 0 0 0 2 3 Diphtheria (immediate) 0 0 0 0 0 Haemophilus influenzae, invasive (24h) 0 0 0 5 7 Hepatitis A (24h) 0 0 0 0 1 Hepatitis B-Acute Infection (7d) 0 0 0 1 2 Hepatitis B-Chronic (7d) 0 0 0 2 28 Board of Health Report January 2016 - Page 5 of 21

Hepatitis C-Acute (7d) 0 0 0 1 0 Hepatitis C-Chronic (7d) 7 1 7 239 235 Hepatitis D (7d) 0 0 0 1 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) 0 0 0 6 15 Measles (rubeola) (24h) 0 0 0 0 0 Mumps (24h) 0 0 0 0 0 Neisseria meningitidis, invasive (24h) 0 0 0 0 0 Pertussis (whooping cough) (24h) 0 0 0 9 16 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 3 2 Tetanus (7d) 0 0 0 0 0 Sexually Transmitted Infections AIDS (7d) 0 0 0 0 0 Chancroid (7d) 0 0 0 0 0 Chlamydia (7d) 61 0 61 1751 1702 Gonorrhea (7d) 15 0 15 544 443 HIV infection (7d) 0 0 0 0 0 Syphilis (7d) 0 0 0 0 0 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 (including WNV) (7d) 0 0 0 0 0 Babesiosis (7d) 0 0 0 0 0 Botulism, foodborne (immediate) 0 0 0 0 1 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) 1 0 1 n/a n/a Chikungunya Non-neuroinvasive Disease 0 0 0 0 0 Cholera (24h) 0 0 0 0 0 Creutzfeldt-Jakob Disease (7d) 0 0 0 0 0 Board of Health Report January 2016 - Page 6 of 21

Cryptosporidiosis (7d) 0 0 0 5 4 Cyclosporiasis (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 7 5 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 8 3 Leprosy (7d) 0 0 0 0 0 Leptospirosis (7d) 0 0 0 0 0 Listeriosis (7d) 0 0 0 0 0 Lyme disease (7d) 0 0 0 7 8 Malaria (7d) 0 0 0 1 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 (2 4h unless bioterrorism suspected then immediate) 0 0 0 0 0 Rabies, human and potential human exposure and animal (24h) 0 0 0 16 1 Reye syndrome (7d) 0 0 0 0 0 Salmonellosis, other than typhoid (7d) 1 0 1 57 40 Severe Acute Respiratory Syndrome (SARS) (immediate) 0 0 0 0 0 Shigellosis (7d) 14 0 14 116 21 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 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 9 11 Board of Health Report January 2016 - Page 7 of 21

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) 0 0 0 11 6 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 6 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 2 1 Yersiniosis (7d) 0 0 0 0 0 West Nile Fever 0 0 0 0 0

* 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.

Shigella Outbreak Update As Incident Command ended on January 4, 2016 for the community outbreak, the Communicable Disease (CD) Team continues its active surveillance on the disease. During the month of January, fourteen (14) additional lab confirmed cases were identified. The disease continues to be community wide.

The CD Team reached out to two “new” daycare/elementary school in efforts to educate the staff on Shigella. 1) The CD Team worked in conjunction with our Daycare Consultant, LuAnn Ostrander, to provide “Shigella” education to a Rockford Daycare who has not been previously identified with the community outbreak. Ms. Ostrander reported after meeting with the Daycare: “She was pleased to have the education. She was not aware of the diseases that can be passed through this route and she listened intently. It all went well. She has my card and I stated that she could call me with any questions or concerns that she may have.”

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2) In addition, the CD Team worked with a “new” elementary school who has not been previously identified with the community outbreak. WCHD requested the school’s assistance in helping to stop the spread of Shigella within your school. Hand washing is the key to end Shigella in your school. To assist you in your school’s effort to stop the spread, WCHD offered the attached documents entitled: • WCHD Info for School with Shigella Outbreak • Hand Washing Prevention Education • Sample School Notification Shigellosis Confirmed Case

The Outbreak can be described in the following graphical presentation and statistical data:

• Domain 3 – Inform, Educate, and Empower During the month of January, a press release was sent regarding Radon Awareness Month. From the release, media interviews were conducted and news stories were reported to the community through print, and television. This story generated over fifteen requests for the Radon Gas Monitor.

Social Norms Marketing (SNM) Campaign Jefferson, Auburn and Harlem High Schools have agreed to host at each school a Tobacco Social Norms Project within their school to change the perception and use of Tobacco at the individual sites for high school students. Each school project is slated to start in February. An assessment to identify Best Practices in regards to messages that resonate with high schools students will be implemented. There will be 15 Students identified at each school that will receive education on Tobacco Prevention, Best Practices regarding Marketing Strategies and each site will conduct a Social Norms Campaign to change the perceptions of Tobacco use and reduce Cigarette Board of Health Report January 2016 - Page 9 of 21

amongst high school students. The Health Promotion NIU (Northern University) Intern will be assisting Tobacco Coordinator with Social Norms Marketing Campaign development, implementation and evaluation within each school.

Substance Abuse Youth Prevention Education All Stars Youth Prevention Education is being provided in 3 Middle Schools in Rockford a total of six (6th and 7th) grade classes and approximately 75-80 students.

Electronic and Social Media Contacts for January 2016

WCHD Website Page 9,957 Page Views 3,440 Sessions 2,634 Users Facebook 392 Avg. Weekly Reach 31 Avg. Weekly Engagements 559 Total Likes Twitter 4.0 k Tweet Impressions 3 New “Likes” 661 Followers Intranet Page 2,728 Page Views 751 Sessions 538 Users

On behalf of the U.S. Department of Health and Human Services Region 5, on Monday, January 11, 2016, the Winnebago County Health Department was the host site for their Northern Illinois press conference regarding 2016 ACA insurance enrollment deadline of January 31. Staff from the Winnebago County Health Department along with several partnering organization help plan and coordinate this event. In total, eleven partners from Federal, State, and Local organizations spoke on the program

accomplishments and urged residents to sign up, or re- enroll before the 31st deadline. Media from print, television and radio covered this story not only on Monday but Tuesday as well.

• Domain 4 – Mobilize Community Partnerships Substance Abuse Prevention Coalition After taking a 2 month break over the holidays, the Winnebago County Substance Abuse Prevention Coalition has resumed its monthly meetings. The Substance Abuse Coalition is still in the assessment phase of the Strategic Prevention Framework (SPF). Data is being collected, focus groups are being formed, several key informant interviews of local leaders/politicians were conducted, as well as a Board of Health Report January 2016 - Page 10 of 21

survey being formed and added to Power 106.3 website for those between the ages of 13-18. The Coalition is hoping to begin the planning phase of the SPF by August of this year. The Coalition has about 10 consistent members of different sectors such as School, Media, Law Enforcement, Religious, Business, Youth Services, and Public Health.

Transform Rockford Dr. Martell continued to represent the Winnebago County Health Department on the Transform Rockford (TR) Healthy Lifestyles Spoke workgroup which met weekly in the month of January to further develop goals and strategies to support the 4 Pillars of health: 1. Improve nutrition and healthy eating behaviors. Eat for Health! 2. Increase physical activity and exercise. Move More! 3. Develop effective and healthy stress management skills. Know It and Own It! 4. Enhance and support positive social and emotional connections. Love and Be Loved! Initial response from the Steering Committee “Red Team” of TR is the need to use more motivational and transformative language.

Social Host Law Promotion ATOD specialist is working with Winnebago County Substance Abuse Prevention Coalition to promote to schools and youth organizations and offer educational opportunities to provide parents and guardians with information about youth alcohol usage and responsibilities of adults in hosting events for which alcohol could be present.

Business First

WCHD continues to participate in the BusinessFirst initiative. In follow up to the January 15th meeting, the WCHD was informed that the City of Rockford will no longer provide administrative support. They have requested support from other agency participants including the Winnebago County Health Department to provide adminstrative support to sustain this initiative. WCHD is proposing a “listening” fee be implemented with the assistance of a third party organization, such as Rock Valley College or the Northern Illinois Center of Non-Profit Excellence program through Rockford University to cover cost and provide an “Advisory” role to support the coordination of agencies that must permit, license, and/or inspect businesses.

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• Domain 5 – Policies and Plans IPLAN Community Assessment The IPLAN Steering Committee has identified locally- appropriate indicators which have been arranged in a data book divided by topic categories according to the Community Health Status Assessment. The Committee has analyzed the data and will develop a method to disseminate the information to local community partners. Partners and community members will be asked to give feedback on the local data that was presented. Participants will then be asked to assist in prioritizing health issues to guide health improvement planning. Community meetings will take place in April 2016 and continue throughout all 4 MAPP Assessments.

Steps of the Community Health Status Assessment: 1. Prepare for the Community Health Status Assessment. 2. Collect Data and core Indicators on CHSA Indicator List. 3. Identify Locally-appropriate Indicators and Collect the data 4. Organize and analyze the Data; Develop a Compilation of the Findings; and Disseminate the Information. 5. Establish a System to Monitor the Indicators Over Time. 6. Identify Challenges and Opportunities Related to Health Status.

Policy Development: Smoke Free/Tobacco Free Outdoor Spaces (Parks, Campus, worksites, etc.) Initiative Goals: • Prevent Tobacco Use among youth • Promote Tobacco Use Cessation among adults and youth • Eliminate Exposure to secondhand smoke • Identify and eliminate tobacco related health disparities among specific population groups

Initiative Objective: By June 30, 2016, the following policy/ordinances will be introduced: • Tobacco Free open spaces • Tobacco/Smoke Free campus policy (school, business, or other institution) • Strengthening the local school tobacco use code, including e cigarettes Community Partners: local community centers such as Blackhawk Boys and Girls club, Winnebago County Administration, local municipalities and chamber of commerce, and Northwest Community Center. Other institutions will be included as policies are adapted. Board of Health Report January 2016 - Page 12 of 21

Contacts with organizations include: Clifford Stoner, Boys & Girls Club –President; David Hicks, Executive Director, Northwest Community Center; D205: Financial Implications: Cost to Tobacco Free Communities grant will provide for the purchase of signs for clubs to post on property; enforcement costs will be provided by club representatives. No revenue will be needed for this policy implementation. Recent activities: Northwest Community Center and the Boys & Girls Club of Rockford have received a pre-assessment of their organizations mission statement, values and programs including information from the Illinois Youth Survey regarding Tobacco use. After reviewing the pre-assessment, the above named organizations have decided to move forward with meeting with their individual boards regarding development of an Outdoor Open Space Tobacco Campus Free Policy (date for directors to meet with their boards has not been determined). The Winnebago County Health Department’s Tobacco Free Communities grant would be used to provide technical assistance and signs to address the enforcement of policy. Once the approval by the organizations Administrative Boards have approved to make changes in the proposed policy initiative, the Tobacco Coordinator will provide assistance with language development for the proposal. WCHD is in the process of contacting other counties with the same policy initiative to determine what policies have been developed for open spaces and compare with current WCHD proposals. Tobacco Coordinator has contacted D205 to determine if current tobacco policy includes electronic cigarette language. Policy Development: Smoke Free/Tobacco Free Multi-Unit Housing Initiative Goals: • Prevent Tobacco Use among youth • Promote Tobacco Use Cessation among adults and youth • Eliminate Exposure to secondhand smoke • Identify and eliminate tobacco related health disparities among specific population groups

Initiative Objective: By June 30, 2016, implement or continue the implementation of 1 smoke free policy for Winnebago County Housing Authority (including tobacco prevention and electronic cigarette), that will be enacted by June 30, 2016.

Community Partners: Winnebago County Housing Authority

Contact: Alan Zais, Executive Director

Financial Implications: Tobacco Free Communities grant will assist in the purchasing of signs to promote Smoke Free policies within facilities of Winnebago County Housing Authority (WCHA). Enforcement for the policy will be provided by staff of WCHA. Recent Activities: The Tobacco Control Compliance Officer has provided Winnebago County Housing Authority with information regarding E-Cigarettes to strengthen their current Smoke Free Tobacco Policy. A meeting will be set to tour all of the Winnebago County Housing Authority sites to assess how Winnebago County Health Department may be able to assist in the education of renters at the sites.

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Policy Development: Smoke Free/Tobacco Free Licensing Initiative Goals: • Prevent Tobacco Use among youth • Promote Tobacco Use Cessation among adults and youth • Eliminate Exposure to secondhand smoke • Identify and eliminate tobacco related health disparities among specific population groups Initiative Objective: By June 30, 2016 the Retail Licensing policy will be introduced to at least 5 communities within Winnebago County.

Community Partners: Winnebago County Administration, local municipality mayor/presidents, and representatives of the law enforcement for each community and county level.

Contact: Chairman Scott Christianson, other municipal leaders.

Financial Implications: Local municipalities and county level administration may see an increase in revenue due to new retail licensure processes. Those communities who have already charged fees for the licensure may not have any new revenue generated unless they have not already asked for licensure of electronic cigarette vendors. Financial implications need to be investigated with municipal leaders and Tobacco Coordinator when discussing tobacco enforcement checks as a component of their retail licensure fees. Currently WHCD provides tobacco retail checks with the assistance of the TEP program and ILCC grant. Grant money may not be needed for checks if local municipalities include costs for retail compliance checks into budget with tobacco retail licensure and revenue generated from licensure.

Recent Activities: The Winnebago County Health Department is working with Winnebago County and conducting an assessment of other counties and communities with a Retail Licensing Policy. Tobacco Coordinator met with County Board Chairman and another County Board Member to discuss Tobacco Control and how the retail licensure could be included as a component for tobacco control strategies. Currently, there is not a policy at this time regarding Retail Licensing in Winnebago County. The goal is to develop a Retail Licensing for Winnebago County. A follow up meeting will need to be set with County Board Chair and advocate County Board member to begin discussion and bring information regarding other community policies to the attention of the county board members. No date has been set for follow up meeting.

• Domain 6 – Enforce Laws EHI Code Enforcement Stats

Monthly FY 2016 FY 2015 Inspection Inspections Inspections Foods 227 1188 1308 Wells 10 40 14 Septic 3 34 43 Loan Inspection 23 138 169

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Administrative In- House Administrative In-House FY 2015 FY 2015 Hearing Hearing Hearing (FY16) Hearing Administrative In-House Month Month (FY16) Hearings Hearing Housing 4 14 33 102 44 120 Foods 0 2 0 11 0 8 Well/Septic 1 1 2 6 1 3

A meeting has been set for February 15th with the Rockford Park District for further discussion regarding the safety of their Splash Blaster water roller coaster ride. The objective of this meeting is to review documentation from the Illinois Department of Labor (IDOL) concerning their involvement associated with safety inspection oversite of this ride. In addition, the WCHD will provide feedback to their “corrective action plan” related to the proposed renovations that would address the “steepness” of the first drop which was linked to several reported injuries.

CoCo Keys continues to remain closed. There has been no communication that the facility has addressed any of the reported health and safety violations. Continued spot checks have been performed to ensure compliance with the closure order.

Illinois Tobacco Free Communities Grant/Smoke-Free Illinois Act Compliance Checks Conducted: 7 Six (6) of the 7 businesses (86%) have been found to be out of compliance of the SFIA. The Winnebago County Health Department is working with the each company through “Willful Compliance” to become compliant with the SFIA.

There were a total of 9 referrals from Winnebago County Health Department’s Environmental Health Services regarding businesses that are not in compliance of the SFIA this month. Referrals provided by the Environmental Health Services will be sent a letter and informational packet referring to the Smoke Free Illinois Act requirements for businesses. A compliance check will be completed within 3 weeks of packets being sent to businesses referred by Environmental Health.

Compliance Check Update on Murphy’s Pub Murphy’s Pub had not implemented all of the actions identified at the site visit and was found to be out of compliance with the SFIA resulting in a SFIA Citation of $250.00 followed by additional compliance checks and escalating citations if violations continue.

Illinois Liquor Control Commission Grant: Tobacco Enforcement Program Tobacco Compliance Checks are scheduled to be completed by Feb. 29, 2016. Currently WCHD is confirming the availability of grant dollars to provide payment to students helping with compliance checks. Three rounds of checks are to be provided each year under grant deliverables. February’s checks will count as round two (2) out of the 3 expected.

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• Domain 7 – Link to/Provide Care iGrow

iGrow – Coordinated Intake for January December Total Total Visiting 2016 2015 YTD FY15 FY16 FY16 FY16 # CIAT Completed (Coordinated Intake 111 102 359 660 Assessment Tool) # Referred to Partner Home Visiting 33 12 89 443 Programs

Audio/Visual Program Hearing and Vision screenings took place at a number of private preschool and K-8 programs. Priority for services remains for Preschool age children with a number of preschools scheduled for screenings for January-May.

Audio/Vision Program Services for January 2016 Grant YTD Grant YTD Hearing Services Totals Vision Services Totals Total Total Screenings 262 1658 Screenings 249 1405 Re-screenings 14 136 Re-screenings 15 167 Referrals 0 0 Referrals 4 32

IPC – Affordable Care Act The ACA Enrollment Center continues to assist consumers with 2016 open enrollment. The current hours for the ACA Enrollment Center are Monday- Friday from 8 a.m. to 9 p.m. and Saturday from 8 a.m. – 2 p.m.

Dr. Martell and Lisa Gonzalez continue to work with the Winnebago County Probations Department to build sustainability for healthcare coverage enrollment for the probations and pre-trial populations. Health Department assists by completing a query of the MEDI system in order to identify those probation/pre-trial clients that have active Medicaid or Medicare coverage. The Probation Department utilizes the information to better refer probation clients for enrollment assistance.

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Q2: Q1: Dec 2016 FY In-person Counselor (IPC) Oct & 2015- TOTAL Nov. Grant Affordable Care Act (ACA) Feb 15, 2015 2015

Scheduled 37 120 157 Appointments:

Walk-in 49 194 243

# Applications Completed 12 91 103 ABE (Medical Card)

# Applications Started* 5 24 29

# Applications Completed 27 108 135 Marketplace (Insurance)

# Applications Started* 6 33 39

Visibility: # Publicized Community Events Held - - -

Number of Events - - - Education: # Educational Presentations

Attendance - - -

Number of Events 2 - 2 Outreach: # Community Booths/Tables

Attendance 70 - 70

Engagement: One-On-One Stakeholder Meetings 37 19 56

Engagement: One-On-One People Contacts 204 411 615

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Women’s Health Services WCHD continues to provide services which are vital to ensuring access to contraceptive services. This service fills this necessary safety net in the community.

January 2016 January January Family Planning 2015 2014 2016 YTD

Number of Clients Seen 149 149 299 397

New Clients 30 30 40 84

Continuing Clients 119 119 259 313

Pregnancy Tests 71 71 153 205

Illinois Breast and Cervical Cancer Program (IBCCP)

Abnormal Screening % IBCCP YTD Enrollment Follow up Completed By Age n=227 YTD Target = 60 Days Target = 417

100% 0% 98% 96% 5% 94% 10% 14% 8% 92% Under 35 90% 35-39 88% 0% 86% 89% 40-49 88% 84% over 50 82% 30%

Breast Cancer Screening Cervical Cancer Screening

The IBCCP Program at WCHD received an additional $35,000 reallocated from other other programs within the state of Illinois. This additional funding will provide services to 40 women who are currently on the priority wait list. Since July 1, 2015, two (2) women have been diagnosed with breast cancer through the program and are under care.

Health Promotion Clinic Activities Total Clients seen by Health Promotion Clinic at 555 N. Court: 113 patients (66 females and 47 males) with 110 visits (66 visits with females and 44 visits with males). Average visit per day is 5.13.

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Integrated Clinic Services by Visit Type

Refugee Health Services WCHD is responsible for coordinating the delivery of health and health-related services to refugees in the designated service area. WCHD has seen the following number refugees during the current month broken out by gender and year to date (YTD).

Nationality Males Females 2016 YTD 2015 Year Total Burma 0 0 0 98 Burundi 0 0 0 12 Colombia 0 0 0 4 Congo 0 0 0 79 Cuba 1 2 3 16 Eritrea 0 0 0 2 Iran 0 0 0 4 Iraq 0 0 0 51 Rwanda 0 0 0 7 Sudan 0 0 0 1 Syria 0 0 0 35

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Dental Sealant Two Dental Providers had seen a combined 433 children the month of December with a total of 13 children receiving 50 sealants from the Dental Sealant Grant. Illinois Department of Public Health (IDPH) will be meeting with potential grantees for the upcoming Oral Health Workforce Project in which WCHD, Rockford Health Council and Rock Valley College will collaborate to pilot a new initiative at the state level in developing and implementing a new certification for Dental Hygienists to become community navigators for oral health services for parents and community members.

Influenza Vaccinations • Flu Shot Billing completed on 90% of community flu clinic participants which included primarily Medicare recipients, Medicaid, State of Illinois employees, and several small businesses within Winnebago County. • Planning will begin this next month to determine action steps for 2016 Influenza season. • A total of 2,324 vaccinations were provided by WCHD in community and some employer flu clinics during influenza vaccination season.

Tuberculosis Care Center Activities

Client(s) Seen New Clients 21 Returning Clients 10 Professional Services Physician Contacts 18 Medication DOT (direct observed therapy) Visits 18 Diagnostic Servicies Total Active Case(s) in Winnebago County (YTD) 1 Total Actives Case(s) Being Medically Managed Outside 1 of Winnebago County (Ogle) (YTD)

• Domain 8 – Assure Competent Workforce

Total Full Time Part-Time and Employees New Separated Employees Employees Seasonal Utilizing Hires Employees Employees FMLA 109 90 19 9 1 1

The Health Promotion Department has an undergraduate student, Alisen O’Hearn from Northern Illinois University, studying Public Health and Health Promotion for the months of January –May. The NIU intern will work with Supervisor and Tobacco Coordinator on several different projects under the Tobacco Free Communities grant.

Environmental Health Improvement Center also has an undergraduate student Dustin Coy from Northern Illinois University who is pursuing a degree in Public Health.

Tishia Mayfield from Rasmussen College is working towards Certification as a Certified Medical Assistant (CMA) in the Integrated Clinics supporting the WCHD Clinical staff. Board of Health Report January 2016 - Page 20 of 21

• Domain 9 – Quality Improvement PHAB UPDATE: 1. Pre-application 100% Complete 2. Application 100% Complete 3. Document Selection and Submission

(detailed sub-steps below) 85% In Progress Documents Submitted 100% Complete Completeness Review Provided 100% Complete

Response to Completeness Review 100% Complete Pre-Site Visit Questions & Request for Additional Documentation 100% Pending Response to Pre-Site Visit Questions and Requests 25% Pending 4. Site Visit 0% Not Started 5. Accreditation Decision 0% Not Started 6. Reports 0% Not Started 7. Reaccreditation 0% Not Started

Winnebago County Health Department received the Pre-Site Visit Questions & Request for Additional Documentation on January 22nd, 2016. Thirty-Five measures were re-opened and eight measures have been re-opened with questions. Extra documentation will be uploaded no later than February 21st, 2016. The site visit is scheduled for March 15th & 16th, 2016.

Domain 10 – Evidence-based Practices

The work is in process to begin the credentialing process through UICOMR (University of Illinois – College of Medicine Rockford) to include participation by the Winnebago County Health Department on the community-wide IRB.

The Health Equity Coordinator will be reviewing and presenting evidence-based models of community engagement to the Leadership Team, Supervisors, and IPLAN Steering Committee to better prepare the groups for their work in the community.

• Domain 11 – Administration and Management

WIC /BBO/ January December Total December Total APORS/HRIF 2016 2015 FY16 2014 FY15 FY16 FY16 FY15 WIC Total Caseload 6306 6525 2578 6450 8,039 Assigned – SFY15 = 84% 87% 77% 8,359, SFY16 = 7,523 FCM (ended 11/30/15) 2560 2728 2,776 APORS/HRIF total 592 127% 3225 107% caseload Better Birth 64 71 200 84 545 Outcomes (BBO) 71% 79% 70% Total Caseload Assigned - SFY15 = 120, SFY16 = 90 Board of Health Report January 2016 - Page 21 of 21

The state of Illinois budget impasse continues to impact reimbursement for expenses covered by state of Illinois grants. Advocacy continues through the Northern Illinois Public Health Consortium, Illinois Public Health Association, and Illinois Association of Public Health Administrators but all programs funded through the state of Illinois are experiencing the same issues.

• Domain 12 – Governance Failure to pass a budget for the State of Illinois continues to impact programs funded solely with general revenue funds (GRF). New Board of Health member, Jaymie Nelson received an official orientation, overview, and introduction to the Winnebago County Health Department on January 11, 2016.

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

Public Health Administrator

Please note that our offices will be closed on Monday, February 15th in observance of Presidents’ Day.