Jun 30, 2017 - compiled training needs for each of our staff based on the Core Competencies of Public Health. .... Custo
Linn County Public Health Annual Report
July 1, 2016 - June 30, 2017
TABLE OF CONTENTS Governing Boards .............................................................................................................. 2 Message from the Director ................................................................................................. 3 Fifty Year Anniversary ........................................................................................................ 4 Governance - Linn County Board of Health ....................................................................... 5 Community Partner Award Recipients ............................................................................... 6 Assessment and Health Promotion Division ...................................................................... 8 Public Health Preparedness............................................................................................... 9 Clinical Services Division ................................................................................................. 10 Chronic Disease............................................................................................................... 11 Healthy Homes ................................................................................................................ 12 Air and Water Quality ....................................................................................................... 13 Environmental Quality ...................................................................................................... 14 Laboratory Services Division ............................................................................................ 15 2017 By the Numbers ...................................................................................................... 16 Performance Management............................................................................................... 17 Financial Reports ............................................................................................................. 18 Public Health Recognition ................................................................................................ 19 Public Health Staffing ....................................................................................................... 20
LINN COUNTY BOARD OF SUPERVISORS
Pictured (left to right): James Houser, John Harris (vice chairperson), Brent Oleson (chairperson), Stacey Walker, Ben Rogers
LINN COUNTY BOARD OF HEALTH
Pictured (left to right): Dr. James Levett, Dr. Mary Tarbox (vice chairperson), Leslie Wright, Mark Taylor (chairperson), Stacey Walker Page 2
Dear Linn County Residents: This year we celebrated the 50th year of the founding of Linn County Public Health. Until 1967, LCPH was Cedar Rapids’ Health Department. (For those interested in the historical advent of LCPH, please refer to page 4.) Your health department, Linn County Public Health, has come a long way in protecting and promoting public’s health in Linn County. In order to provide public health services to our residents, Linn County Public Health has built a robust infrastructure, but our most important infrastructure is our workforce – our colleagues, who work 24/7 to ensure that our water, food and air are safe. Each of my team members, at each level, plays a vital role to advance public’s health in our county.
Pramod Dwivedi Health Director
During the past fiscal year, we have collectively embarked on a vision to assist our staff to excel in their work. We compiled training needs for each of our staff based on the Core Competencies of Public Health. The supervisors and managers will be working with their staff to identify appropriate training/education in the next few months. We cannot continue to improve the health of our residents without a well-trained, competent workforce. In the aftermath of last year’s flood, our staff responded with a two-day rapid response to inspect more than 130 restaurant and retail food establishments and 190 potentially affected wells. Since 2013, more than 62% of K-12 schools in Linn County have been tested for radon (53/85). The ambitious Health Improvement Plan and State Innovation Model work that we began more than a year ago continue to grow with more than 30 partners joining together and advancing public’s health across Linn County. Fifteen community partners helped us purchase software to connect and combine medical and social service needs of our clients. This is a significant accomplishment. Our Health Improvement Plan, under the auspices of Together! Healthy Linn, is working with our stakeholders/partners to implement the action plans. The three focus areas, once again, are: Social Determinants of Health, Behavioral Health and Health Promotion. Community partners and LCPH staff received funding assistance from the National Association of Chronic Disease Directors to participate in the Step It Up!: Action Institute to Increase Walking and Walkability. The Linn County team developed an action plan to assess and recommend measures to improve walkability within Linn County in areas of high need. As always, our Clinical Services has done remarkable work. This year the number of refugees who visited the clinic has increased by over 300%. Several hours for each refugee is dedicated to assist them with their medical needs. In light of uncertainty about our funding and programming, we remain confident that our good work to improve public’s health in Linn County will continue. That’s our commitment to you. We welcome your comments and questions, either by calling us at 319-892-6000 or by emailing to us at
[email protected]. You can also follow LCPH @LCPublicHealth. Check out our Facebook page www.facebook.com/LCPublicHealth. You can also follow me on twitter @pdwivedi9. Thank you! Sincerely, Pramod Dwivedi
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2017 2015 Linn County Public Health was awarded national accreditation from the Public Health Accreditation Board
2011 Healthy Linn Care Network merged into Linn County Public Health
2008 2003
Greatest flood hit Cedar Rapids. (1st full Incident Command structure was utilized)
Linn County Public Health implemented a Preparedness Program
1989 Linn County Public Health moved to current facility
1978 Linn County Public Health implemented a Blood Lead program
1974 Linn County Public Health was certified as the Air Quality permitting and monitoring program provider for Linn County.
1967 Cedar Rapids Health Department became Linn County Health Department after establishment of Chapter 137 of the Code of Iowa
1964 Public Health moved from City Hall to Public Works building
1946 Cedar Rapids Gazette story on Very Bad sanitation, mentioning Iowa Public Health Nursing Association, which started in 1920
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LINN COUNTY BOARD OF HEALTH Roles: Support the mission of public health Discuss health issues and concerns, solicit input and share plans for public health
with business and community leaders Develop public health policy based on data and community input Assure compliance with legal responsibilities (Iowa Code/Iowa Administrative Code) Understand and support quality service provision and fiscal accountability
Board of Health (Board) Committees Community Health Collaboration BOH Liaison: Dr. James Levett, Dr. Mary Tarbox, Leslie Wright The Community Health Collaboration Committee has the responsibility for reviewing the scope of community health activities ongoing or needed in the community, and for making recommendations to the Board and to the Health Director for opportunities for community collaborations in the general public health system or for programs and services under the purview of the Linn County Public Health Department.
Finance and Administrative Review BOH Liaison: Pramod Dwivedi The Finance and Administrative Review Committee oversees the financial management of the agency, and make recommendations for improvement to the Board as appropriate. The committee also has responsibility for periodically reviewing the personnel policies of the agency and making recommendations to the Board as appropriate. It advises the Health Director on personnel matters and recommends approval for all budgeted positions in the agency. The Committee is advised by the Health Director of any personnel issues and grievances. Policy and Government Relations BOH Liaison: Stacey Walker, Mark Taylor The Policy and Government Relations Committee has the responsibility for reviewing the annual work program and making recommendations to the Board as appropriate. It is responsible for evaluating all programs and services and recommending changes to the Board as appropriate. It oversees the agency’s quality assurance measures. The committee is responsible for seeing that the Board develops an annual strategic plan. It reviews proposed agency policies and make recommendations to the full Board. It considers the enactment of any Board policy or ordinance regulating the public’s health and makes recommendations to the full Board.
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Community Partner Award Recipients Caleb Gates Catholic Charities
Paula Land (not pictured)
Wanda Miller City of Cedar Rapids
Catherine McAuley Center
In recognition of their invaluable contributions and dedication in supporting healthcare for the refugee population of Linn County.
In recognition of her collaboration with public health to ensure foodservice safety in Cedar Rapids.
Kim Ott
Brandon Whyte
SIM C3 Coalition
Metropolitan Planning Organization
In recognition of her contributions to the State Innovation Model Community Care Coordination program.
In recognition of work to promote active transportation in Linn County, including enhanced trail connections, Safe Routes to School, and complete streets policy adoption..
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Director’s Choice Award Recipients Sherri Schuchmann and Lori Smith
Marty Ross
Linn County Public Health
Linn County Facilities
For their valued contribution to public health and providing excellent customer satisfaction.
For his endless smile and patience in fixing everything that breaks.
Linn County Employee Recognition Recipients Matt Boyle (IT-GIS), Robin Robinson, Peter Konrad (IT-GIS), Tim Slothower, Mechelle Carter, Jason Siebrecht (IT-GIS), Jia Timmerman, Shane Dodge, Vildana Tinjic, Casey Jacobson, Jim Hodina, Chase Moffitt - Teamwork Nominated by Larry Hlavacek
Shelby Burns - Customer Service Nominated by Chase Moffitt and Brianna Gabel
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PUBLIC HEALTH IN ACTION ASSESSMENT AND HEALTH PROMOTION LCPH obtained hospital and clinic syndromic surveillance data for one Linn County health system through the Centers for Disease Control and Prevention platform beginning in October 2016.
LCPH staff provided education that resulted in updating Linn County Ordinance Chapter 42: Social Host Ordinance The Sexual Health Alliance, supported by LCPH, conducted the second iteration of a school sexual health curriculum assessment. One Linn County school district implemented sexual health curriculum district-wide in FY17. LCPH staff contributed to the Marion Independent School District Safe Routes to School plan, and will provide education and evaluation post-implementation. Community partners and LCPH staff received funding assistance from the National Association of Chronic Disease Directors to participate in the Step It Up!: A ction Institute to Increase Walking and Walkability.
The Assessment and Health Promotion (AHP) Branch has four core functions: Assessment and Data Analysis, Community Collaboration, Health Promotion, and Planning. AHP serves as an internal resource to LCPH, and as a resource within Linn County. AHP staff analyze and interpret public health data, conduct assessments of community health needs and identify strategies for health improvement, conduct public health planning, collaborate with community members to identify and implement best practices to address needs, promote health through coalitions and health communication initiatives, and ensure public health preparedness. AHP staff and the Together! Healthy Linn committees continue to work on the action plans linked to the 2016-2018 Community Health Improvement Plan (CHIP). In FY17, AHP staff conducted an evaluation of the 2015-2016 Community Health Assessment (CHA) and CHIP process, developed a communication plan, and developed a dashboard to measure progress on the objectives in each of the three strategic issue areas: Social Determinants of Health, Behavioral Health, and Health Promotion. In FY17, the overlap of activities identified in the CHIP and the Linn County State Innovation Model (SIM) is especially noteworthy and demonstrate community momentum and commitment to the CHIP and the SIM project. Diabetes, Data Sharing, Access to Care, and Social Determinants of Health are all areas of the CHIP which align with the SIM project. During FY17, community resource assessments for obesity and diabetes were completed, and an existing diabetes committee focusing on CHIP diabetes and obesity objectives transitioned into the SIM Diabetes Subcommittee. Prediabetes education, coordination, and outreach to high-risk groups is also supported by both projects. Linn County Step It Up! Action Institute Increased utilization of hospital data, a The Team take a break from conducting a walkabilsustained focus on data related to ity assessment to pose for a photo. Social Determinants of Health, and improving access to care by moving forward with a referral system are initiatives supported by both the CHIP and the SIM project.
LCPH staff championed for Double Up Food Bucks at a local farmer’s market, thus increasing access to AHP hosted four students, who worked on projects related to proposing locations produce among low income for community gardens, promoting healthy concessions, increasing LCPH populations. presence on social media, and ensuring preparedness plans are up-to-date. Page 8
PUBLIC HEALTH PREPAREDNESS
PUBLIC HEALTH IN ACTION
Ensuring public health preparedness is noted in the Linn County Public Health mission statement and supported by all branches in the agency.
LCPH partnered with Linn County’s Healthcare for the Homeless Coalition to provide communication and response supplies which can be used to connect with the homeless population in an emergency.
The preparedness program receives public health emergency preparedness (PHEP) funding through federal and state initiatives. The funds support development and implementation of identified public health capabilities. In 2016 the stage was set to convert previous preparedness funding structure from small healthcare coalitions to a version based on hospital reporting patterns for trauma, stroke and cardiac. LCPH went from a two-county (Linn and Jones) coalition to a six-county version with the addition of Benton, Clayton, Delaware, and Dubuque. PHEP, Hospital Preparedness Program (HPP), and EMS System Development Funding for each county is in one budget with LCPH as the fiscal agent. Challenges include the lack of locally designated funding which previously supported many Linn response partner projects. An advantage is the opportunity to collaborate with EMS, hospitals, and public health departments on preparedness capabilities. Linn is in IDPH Service Area 6A. There are plans to merge 6A with IDPH Service Area 6B in future grant years. 6B has eight counties. The funding structure did not change until FY18, however planning for the change started in November 2016 as the FY18 grant called for the six-county collaborative application. Although there are many unknowns with the FY18 application and funding process, LCPH continued to work with local partners on measures to strengthen the public health system. Through exercises and actual events, LCPH was able to test capabilities. Postevent reviews were held to determine what worked and identified areas of improvement. Examples of capability tests in FY17 were:
Community recovery Emergency public information and warning Emergency operations center coordination Fatality management Interoperable communications Mass care Medical countermeasure dispensing Responder safety and health
At the 2017 Iowa Governor’s Conference on Public Health, LCPH staff presented lessons learned in the 2008 Flood applied in the 2016 Flood response. This provided an opportunity for public health peers to learn from others’ experiences. LCPH utilized grant funding to provide EMS partners with emergency response bags with nonpermeable surfaces.
Preparedness grant funds were used to purchase portable lighting for His Hands Free Clinic. Shortly after purchase, the clinic was linked to a “brown out” which dimmed lighting. With the use of the portable lighting, clinic services were not impacted.
In partnership with Mercy Medical Center, UnityPoint Health - St. Luke’s Hospital and other healthcare providers, a community mass vaccination exercise was conducted in December 2016. Assessments were completed to identify partners who could assist to vaccinate the local population in a declared public health emergency.
Volunteer management Page 9
PUBLIC HEALTH IN ACTION CLINICAL SERVICES Clinical Services was awarded an additional $100,000 for three years from the Iowa Department of Public Health (IDPH) to control Hepatitis C (HCV) and human immunodeficiency virus (HIV) and address the increasing trend of sexually transmitted infections (STIs) in Linn county. This funding includes an outreach staff position for HIV/HCV/STI testing. Key partners in this initiative will aggressively take action to prevent and contain these communicable diseases. These partners include the Iowa Harm Reduction Coalition (IHRC), the University of Iowa Carver College of Medicine, Area Substance Abuse Council (ASAC), the Ryan White Part B Case Management program, Johnson County Public Health, and the IDPH HIV/Program Regional Outreach Liaison (ROL). Evidence -based activities include broad, free, condom distribution, education for medical providers about the need for HIV/HCV/STI testing, seamless referral processes for positive individuals, and prophylactic preventive treatment for those at risk for acquiring HIV pre-exposure prophylaxsis (PrEP).
Refugee Services LCPH has taken the lead in addressing the health care needs for primary and secondary refugees resettling in our community. Due to the new Federal Administration guidelines concerning refugees, there has been a decrease in the resettlement of primary refugees in Linn County. However, we have seen an increase in the number of refugees relocating to Iowa from other states. LCPH continues to collaborate with community partners to address the health needs of refugee clients, beginning with access to care and coordination of services. Reportable Communicable Diseases One of the mandatory, essential functions of public health is surveillance and containment of reportable communicable diseases/illnesses. Of significance in FY17, LCPH investigated 2,027 reportable diseases. Specifically, 1,421 Chlamydia, 343 Gonorrhea, 31 Syphilis, and 227 non-STI investigations were conducted.
HIV, 16, 1%
Syphilis, 24, 2%
Gonorrhea, 216, 15%
Chlamydia, 1152, 82%
Sexually Transmitted Infections
Sexually Transmitted Infections Linn County continues to see high rates of sexually transmitted infections (STI’s). With the addition of a full-time nurse and the engagement of community partners for STI/Hepatitis/HIV, outreach testing and treatment has resulted in getting individuals with these infections into more timely treatment. The CTR/HIV/HCV/Immunization funding increases that LCPH has received demonstrates the priority for evidence-based strategies to address this growing public health issue. Immunizations LCPH supports vaccine-preventable disease prevention in the community by providing immunization services. Linn County has expanded immunization services to include services for patients with commercial insurance, patient assistance for adults without insurance, and international travel vaccines. Within the next year, LCPH will be providing immunizations for patients with Medicare. To help prevent illness when traveling, LCPH offered 338 international travel clients advice, counseling and immunizations in our International Travel Clinic. Individuals learned more about the immunizations that are required or recommended for their trip. Education regarding disease or infection that immunizations and medication cannot prevent or treat is provided along with risk reduction strategies for minimizing the likelihood of becoming ill.
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CHRONIC DISEASE MANAGEMENT
PUBLIC HEALTH IN ACTION
The State Innovation Model (SIM) Community Care Coordination (C3) grant was awarded to LCPH in February 2016 with work beginning in March 2016. The C3 will work to establish community care coordination to better connect medical and social service providers during a developmental year (2016-2017) and two subsequent implementation years (2017-2019). The C3 quickly formed and is completing a referral system assessment, studying community/population health technology, assessing current resources in the areas of diabetes, obesity and tobacco and studying mobile health delivery systems.
Linn County Public Health partnered with the Eastern Iowa Health Center and the Cedar Rapids Medical Education Foundation for a prediabetes screening event held at the Oakland Road Hy-Vee. The aim was to raise community awareness of prediabetes through screening, A1C testing and Diabetes Prevention Program referral and education. A1C testing on 23 individuals was completed. Out of 23 A1C tested individuals, three were found to have prediabetes and one was found to have diabetes. Sixteen blood pressure checks found six individuals with prehypertension and five with hypertension.
LCPH staff are involved in the Diabetes Disparities group working to address diabetes through the CHA-CHIP and SIM C3 work group. The first in a series of community screenings took place in February 2016 to screen persons for pre-diabetes and make referrals to the Diabetes Prevention Program. While many are familiar with type 2 diabetes, few are aware of prediabetes, a condition that affects one out of three adults. Having prediabetes means your blood glucose (sugar) levels are higher than normal—but not high enough to be diagnosed as diabetes. Prediabetes can lead to heart disease, stroke, and often leads to type 2 diabetes. Although providers screen regularly for diabetes, most do not screen for prediabetes. In order to raise awareness of this health condition, the Centers for Disease Control and Prevention and the American Medical Association began a Preventing type 2 diabetes initiative. The goal of this initiative is to increase prediabetes screening, testing and referral to diabetes prevention programs (DPP).
The Care For Yourself and WISEWOMAN programs offer uninsured and underinsured women access to breast cancer and cervical cancer screenings, diabetes and heart disease screenings. During FY16, 146 Through a partnership with women were screened. Partnerships continue with Proteus, Inc. allowing Proteus, this year saw screening for screenings of migrant farm workers in outlying county areas. rates for female migrant farm workers triple in numbers. Evening LCPH staff continue to participate in the Linn County Community events increased from one to three Partnership, helping with open enrollment and year-round special enrollment periods for the Affordable Care Act. During FY16, a trained separate events. Additionally, a AmeriCorps member, with LCPH, assisted the Sixth Judicial District partner for mammography probation and parole officers with community members exiting screening, Marengo Memorial incarceration to insure them and maintain access to needed medical care Hospital, purchased their own in an effort to reduce community-wide recidivism rates. mammography unit. Page 11
PUBLIC HEALTH IN ACTION HEALTHY HOMES In 2013 the Linn County Public Health Healthy Homes Branch kicked off the Radon Initiative Partnership in Schools or RIPLS program. Schools buildings, just like any other building, can have elevated levels of radon that expose children and staff during the course of a school day. Children spend approximately one-third of their time in school. The United States Environmental Protection Agency (EPA) recommends testing schools and mitigate if confirmation sampling shows elevated radon levels of 4.0 pCi/L (picocuries per liter) or more.
Lead Poisoning This was another successful year working with community partners to reduce the harm of lead poisoning. Through partnership with the City of Cedar Rapids Housing Services and funding from the Department of Housing and Urban Development, thirty-five families received lead hazard control assistance, which resulted in lead hazard reduction and lead-safe housing. Many activities to reduce lead hazards included window replacement, exterior siding and flashing installation, replacement of deteriorated wood or structures, stabilizing defective paint, and using safe work practices. This comprehensive remediation could not have happened without the Cedar Rapids Housing Services staff and expertise.
Along with successes came challenges. In 2012, the CDC Advisory Committee made recommendations to the CDC, one of which included changing the reference value from 10ug/dL to 5ug/dL for lead poisoned children. At this same time there was a 94% cut to the CDC Healthy Homes-Lead program budget. According to the National Center for Linn County has twenty-four Healthy Housing (NCHH) 2014 Fact Sheet, just over a quarter of all school districts, eleven public and children in Iowa live in households with high housing cost burden and thirteen private districts. Since one in six children live in poverty. These potential effects are exacerbated 2013, forty-five percent of the by the age of Iowa’s housing stock and lack of property maintenance public school districts and twenty- codes. In response to the these challenges, LCPH is developing options to one percent of the private districts address alternate funding sources and community education. have participated in the RIPLS program. As part of the program, Radon schools educate students and staff Linn County Public Health and Mercy Care system conducted a pilot about radon in a variety of means project to increase radon awareness by engaging medical providers to incorporate radon education and provide radon test kits or information on such as automated phone calls, radon test kits at the time of a well-child visit. The results of the program newsletters, and websites. were submitted to the National Association of County and City Health Officials (NACCHO) Model Practices Program. In March of 2017, LCPH Three hundred ninety four schoolrooms have been tested for was honored that this program was selected as a Promising Practice, which indicated that the program exhibits the potential for becoming a radon in FY17. Overall, 2,137 schoolrooms have been tested for future model practice. Of 461 radon test kits analyzed, 21% had higher than 4.0 pCi/L, the benchmark set by the EPA for action or intervention. radon (2014 - 2017).
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ENVIRONMENTAL PUBLIC HEALTH
PUBLIC HEALTH IN ACTION
Air Quality In the spring of 2017, Linn County Public Health, the City of Cedar Rapids, and a consortium of local partners kicked-off “Solarize Cedar Rapids – Linn County.” Together, over 103 homeowners in Linn County took advantage of discounted solar pricing through a limited-time solar group purchase program. Linn County Public Health participated in over 20 Solar Power Hours (free one-hour seminars), educating homeowners on the benefits of solar energy. The program results include:
The American Lung Association (ALA) issued their annual “State of the Air” report in April. ALA uses a grading system that is more stringent than the EPA’s Air Quality Index (AQI). Linn County received an “A” for ozone pollution with no “ALA” orange days recorded and a “C” for particle pollution with three (3) “ALA” orange days reported.
More than 601kW of installed solar production capacity. Annual saving of $70,628 in utility cost A reduction of 1,174,660 pounds of CO2 per year A reduction of 280,480 gallons per year of water used in energy production.
The enhancements to the Grants to Counties Well Water Program water sampling process have been very successful. We now have arsenic results for over 140 individual wells in Linn County. We are also providing education on well maintenance and interpreting Increasing well rehabilitation funding from $600 to $1000 per well. sample results when homeowners Increasing well plugging funding from $475 to $575 per well. apply for the GTC program. With Increasing education, equipment, and advertising funding by 100%. these changes, we anticipate the For the first time, allowing reimbursement of arsenic testing in well interest in this program will water at actual costs. continue to grow as we increase our marketing efforts. Linn County Public Health took advantage of these changes bringing $20,568 to Linn County residents, an increase of 13% from the previous year with the majority of the funds focused on private well water testing. LCPH’s Water Quality Staff put in place a plan that focused on well sampling, including arsenic with new procedures. This included the creation of a new application form, updates to the Standard Operating Procedures (SOPs), and changes to the setup of the LCPH database to allow better data sharing with the Linn County Geographic Information System (GIS). Water Quality The Grants to Counties (GTC) Program was established in 1987 when our legislature passed the Iowa Groundwater Protection Act to help prevent further contamination of one of Iowa's most precious resources; our groundwater. Grants are made available to local county health agencies to provide financial assistance to their residents for private water well services. This fiscal year, the State of Iowa made several revisions the program funding including:
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PUBLIC HEALTH IN ACTION ENVIRONMENTAL PUBLIC HEALTH (continued) For yet another year, local and state jurisdictions did not receive the needed legislative support to properly fund our local food safety programming. After passing 3-0 by the subcommittee, Senate Study Bill 1169 was not brought to the full committee for vote. As a result, it died in the 2017 Iowa legislative session. Food license fees have remained unchanged since 2008. Meanwhile, Linn County helped over 150 new or remodeled food establishments open in FY17 and inspected 79 primary and secondary school cafeterias. We review construction documents, provide on-site consultation, and train staff during these inspections, yet local programs are prohibited by Iowa Code to charge for these services. Overall, Linn County supplements each of the approximately 1,500 licensed food establishments by an average of $100 each, which comes from the Linn County General Fund.
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Food Safety In 2017, Linn County Public Health joined with the retail food industry to form the Linn County Food Safety Advisory Council. The Advisory Council consists of 17 industry representatives ranging from family owned businesses to large food chains, grocers, and schools. The advisory council advises Linn County Public Health (LCPH) on matters that directly concern the agency’s administration of the food safety program for Linn County and specifically addresses the following two important aspects of the local food safety program:
Industry and Consumer Interaction: How LCPH can effectively
provide information on food safety, strategies, and interventions to control risk factors that may lead to food borne illness. Education Outreach: How LCPH can effectively foster outreach through industry recognition program, websites, newsletters, food safety campaigns, training, and other programs that increase awareness of methods to prevent foodborne illness.
In its first year, the Food Safety Advisory Council identified six goal areas, making significant progress on the first three: 1. 2. 3. 4. 5. 6.
Retail Food Service Employee Training Networking of Industry Professionals Understanding Product Dating (Voluntary and Regulatory) Equipment Best Practices Implementation of Food Code Food Waste / Food Rescue Strategies
LABORATORY SERVICES
PUBLIC HEALTH IN ACTION
The Laboratory Services Division provides clinical diagnostic testing, disease surveillance, environmental testing, and emergency response support. Analytical and public health laboratory information is used to assess health outcomes by the other divisions in Linn County Public Health, governmental and non-profit agencies, as well as the private citizens of Linn County.
In FY17 Laboratory Services fully implemented an Air Quality Alert function within the Linn County Notify-Me system. This allows Linn County residents that are most sensitive to air quality level to be able to sign up to receive notifications and updates via email and/or text message when the air quality has or will deteriorate to the point that it could affect their or their families’ health. In Fiscal Year 2017, air quality improved from FY16 with no days that would have been considered Unhealthy. Good (Green) days increased from 268 days to 301 days.
Water quality monitoring is in place to ensure that the drinking and public recreation waters are safe. The LCPH Ambient Air Monitoring program is in place to ensure that the regulatory permitting policies that are currently in force are sufficient in maintaining the National Ambient Air Quality Standards (NAAQS) set by the Environmental Protection Agency (EPA).
..air quality conditions are:
Good Moderate Unhealthy for Sensitive Groups Unhealthy Very Unhealthy Table 3 – FY17 AQI Values
An Air Quality Index (AQI) value of 100 Linn generally corresponds County to the NAAQS for the AQI Values criteria pollutant, for FY17 which is the level EPA has set to protect public health. AQI values below 100 are 301 Days generally thought of as satisfactory. When 64 Days AQI values are above 100, air quality is 0 Days considered unhealthyat first for certain 0 Days sensitive groups of people, then for 0 Days everyone as AQI values get higher.
Laboratory Services, under Clinical Laboratory Improvement Act (CLIA) certification, provides extended Point of Care testing for clients visiting the Clinical Services clinic. This service brings quicker results, often allowing results to be available at the time of the client visit.
To encourage private well owners to test their wells, Laboratory Services provided analytical assistance under the Grants to Counties (GTC) program. Water quality assessment testing for Coliform and Nitrates was offered along with a one-time Arsenic test to qualified Linn County private well users. This program also assisted private well owners in the plugging and rehabilitation of their wells to help protect ground water resources.
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4,840 Immunizations Administered 2,476 Client visits to the clinic
301 Days the Air Quality Index was in the Good category 1,853 Water samples tested 1,099 Number of Twitter followers 43,568 Immunization audits were completed 258 Pre-opening inspections for 195 new restaurants and grocery stores
2,432 Permitted industrial and commercial emission points 28 After-hours calls received on the 24/7 phone line Page 16
2017
2016
2017
2015
Permits and Licenses Issued
2016
2015
Environmental Related Disease
Air Quality Construction Permits
127
275
296
Cryptosporidiosis
50
33
23
Retail Food Licenses
1501
1244
1226
E. Coli
22
13
10
Septic Permits
173
198
181
Salmonella
52
41
40
Temporary & Mobile Food Licenses
194
245
288
Well Permits
28
98
77
Number of Days AQI exceeded 100 (Orange)
0
2
0
55
72
67
Number of Days AQI 50 - 100 (Yellow)
64
79
119
Food Inspections
1245
1909
1444
Number of Days AQI below 50 (Green)
301
284
240
Blood Lead Screens Managed
4676
4107
3104
EBL tested children (not confirmed)
52
59
44
Hotels
28
9
14
Public Pools and Spas
30
42
86
Tanning & Tattoo Facilities
31
56
32
School Buildings Tested for Radon
12
16
19
Water Samples Collected by LCPH
393
290
298
Inspections & Assessments Air Quality Inspections (Industry)
Water Samples (tests)
1853 1705 1844 (3068) (2678) (2821)
Outreach / Education
Air Quality
Lead Poisoning Percent of Elevated Blood Lead Levels in Children Number of Homes That Have Tested and Met Iowa Lead Dust Clearance
1.11% 1.44% 1.42% 35
16
17
461
506
665
Radon Number of LCPH supplied short-term radon kits for LC residences
Percent of LC homes tested with levels 21.0% 38.1% 28.9% above 4 pCi/L Clinical Services Immunizations Given
5488
4887
4463
80
Refugee Visits
177
54
