Minnesota Local Public Health
Planning and Performance Measurement Reporting System
2005 Performance Measures Results
Compiled by the Office of Public Health Practice
Community and Family Health Division
For more information contact: DeeAnn Finley at [email protected]
Introduction
Introduction to the 2005 Performance Measures
This report contains draft analyses of the data submitted on the 2005 performance measures for
the six areas of public health responsibility. These include:
•
•
•
•
•
•
Assure an Adequate Local Public Health Infrastructure
Promote Healthy Communities and Healthy Behaviors
Prevent the Spread of Infectious Disease
Protect Against Environmental Health Hazards
Prepare for and Respond to Disasters and Assist Communities in Recovery
Assure the Quality and Accessibility of Health Services
All community health boards/local public health departments reported for a total of 77 reporting
entities (this includes counties, multi-counties and cities). This was the first time local public
health reported on the performance measures, and the data should be viewed cautiously and as
preliminary. The purpose of the pilot test was to verify the performance measures so that
improvements could be made for future reporting.
Very little documentation on the performance measures was provided to local public health, so
local public health departments interpreted questions differently. The MDH and the State
Community Health Services Advisory Committee (SCHSAC) learned a great deal about the
performance measures and how to improve them from the pilot test.
The draft analyses contain the questions and the responses to those questions. Generally, the
percentages listed in the draft analyses are the percentages of entities that reported a particular
response out of 77. The analyses are draft, and responses provided by local public health
departments were not edited. Because of the limitations of the documentation, training and
reporting, use of this data for purposes beyond internal department reflection is highly
discouraged.
Summary Analysis of
Assure An Adequate Local Public Health Infrastructure
1) The CHB has reviewed, signed and returned the assurances and agreements document provided by the MDH.
•
•
75 entities responded yes (97%)
2 entities responded no (3%)
2) The composition of the CHB meets the requirements required by MS 145A.03, subd. 4.
•
77 entities responded yes (100%)
3) The CHB met at least twice during the past year as required by MS 145A.03, subd. 5.
•
77 entities responded yes (100%)
4) The CHB has in place written procedures for transacting business and has kept a public record of its
transactions, findings, and determinations as required by MS 145A.03, subd. 5.
•
77 entities responded yes (100%)
5a) The CHB has appointed an agent as required by MS 145A.04, subd. 2.
•
77 entities responded yes (100%)
5b) The agent’s name, title and address are:
•
77 entities responded (100%)
6) Check all that apply:
Organization of CHB
The CHB serves a population of more than 30,000
The CHB serves three or more contiguous counties
The Human Services Board has assumed the powers
and duties of a CHB
Number of entities
71 (92%)
27 (35%)
10 (13%)
7) The CHB has a CHS Administrator who meets the requirements of Minnesota Rule 4736.0110. (Note: these
requirements pertain to CHS Administrators who were appointed after March 21, 1994)
•
•
•
67 entities responded yes (87%)
1 entity responded no (1%)
9 entities responded CHS Administrator was appointed before March 21, 1994 (12%)
8) The CHB has a medical consultant in accordance with MS 145A.10, subd 3.
•
77 entities responded yes (100%)
Draft June 22, 2006
1
9) The public health department or CHB designated staff with knowledge and experience in the following areas
to serve as contact(s) to the MDH:
•
•
•
77 entities responded with a contact for the following areas (100%)
o Assure an Adequate Local Public Health Infrastructure
o Promote Healthy Communities and Healthy Behaviors
o Prevent the Spread of Infectious Disease
o Protect Against Environmental Health Hazards
o Prepare for and Respond to Disasters, and Assist Communities in Recovery
o Assure the Quality and Accessibility of Health Services
o Maternal and Child Health
3 entities responded with a different contact for all the areas (4%)
9 entities responded with the same contact for all the areas (12%)
COMMUNITY HEALTH ASSESSMENT
10) A process is in place to complete a thorough community health assessment that assesses the six Areas of
Public Health Responsibility by December 31, 2009 for reporting new community priorities on February 1,
2010.
•
•
60 entities responded yes (78%)
17 entities responded no (22%)
11) The completed community health assessment of the six Areas of Public Health Responsibility was
presented to the CHB within the past five years (January 1, 2005-December 31, 2009).
•
7 entities responded 2005 (9%)
12) Were any of the six Areas of Public Health Responsibility updated in the community health assessment
during the past year?
•
•
17 entities responded yes (22%)
60 entities responded no (78%)
Areas of Public Health Responsibility
Assure an Adequate Local Public Health Infrastructure
Promote Healthy Communities and Healthy Behaviors
Prevent the Spread of Infectious Disease
Protect Against Environmental Health Hazards
Prepare for and Respond to Disasters, and Assist
Communities in Recovery
Assure the Quality and Accessibility of Health Services
Number of entities that have updated
community health assessment during
2005
7 (9%)
11 (14%)
10 (13%)
6 (8%)
10 (13%)
8 (10%)
If yes to question 12, answer questions 13-16. If the community health assessment has NOT been updated
within 2005, skip to question 17.
Draft June 22, 2006
2
13) MS 145A.10, subd 5a requires the community health assessment to be developed with community
participation. The following methods were used to gain community input:
Methods to gain community input
A community survey was conducted
Focus groups were conducted
Key informant interviews were conducted
Community forums were convened
Other.
Methods were determined in partnership with
community/tribal leaders
Methods were used that were appropriate to the racial,
ethnic, and tribal populations in the area
Materials were available in appropriate languages
Other methods to gain community input
Coalition building with community partners in
assessment and planning
Task Forces and Coalitions
School readiness assessment tool
person on the street interviews
CHS Advisory Committee
Agency evaluation was conducted by a consulting firm
CHS Advisory Committee and PH Staff
Student survey with one community in Wright County
Number of entities that responded
4 (5%)
8 (10%)
8 (10%)
6 (8%)
See below table
5 (6%)
5 (6%)
4 (5%)
Number of entities that responded
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
14) Outreach efforts were made to ensure that the following populations were engaged in the assessment
process:
Populations engaged in the assessment process
Populations of color
American Indians
Special groups in the community
Existing community groups
Youth
Other populations engaged in the assessment
process
Staff members
English as a second language
Number of entities that responded
1 (1%)
2 (3%)
10 (13%)
12 (16%)
6 (8%)
2 (3%)
1 (1%)
15) The community health assessment reviewed the following kinds of data:
Data reviewed in the community health assessment
Student Survey data
County Health Tables data
WIC data
Data on racial and ethnic disparities
Community assets
Draft June 22, 2006
Number of entities that responded
14 (18%)
13 (17%)
7 (9%)
8 (10%)
11 (14%)
3
Other data review in community health assessment
Community emergency preparedness plans and resources
Population statistics
Community Opinion Poll in both Cottonwood and Jackson
Counties by Mellman Group
Environmental risk data; methamphetamine trends report
Hospitalization records, American Heart Association data,
Dental Information, BRFSS, American Cancer data, School
district data
Number of entities that responded
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
16) The community was notified of community health assessment and planning activities: [check all that apply]
Method used to notify community about community
health assessment and planning activities
In-person meetings or telephone conversations
Press release
Legal notice
Mass mailing
Provided information at community meetings
Other methods used
Emergency preparedness council members and partners
Schools
Newspaper articles, church bulletins, flyers
Press coverage, notification of Board of Health
Meetings
Number of entities that responded
10 (13%)
7 (9%)
4 (5%)
4 (5%)
11 (14%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
LOCAL PRIORITIES
17) A process is in place to develop and report local priorities by February 1, 2010.
•
•
63 entities responded yes (82%)
14 entities responded no (18%)
18) What was the last year the list of local priorities was presented to the CHB?
•
74 entities responded (96%)
Last year list of priorities
was presented to CHB
2006
2005
2004
2003
2002
2001
Draft June 22, 2006
Number of
entities that
responded
2
31
30
9
1
1
Percentage
3%
40%
39%
12%
1%
1%
4
Report on question 19 in 2010.
19) Community input was obtained during the prioritization process from: [check all that apply]
• Community Health Advisory Committee
• Schools
• Outreach to populations of color/American Indians
• Local health department or CHB staff
• Governing board
• Families and Children & Youth with Special Health Needs
• Community coalitions or groups
• Other. Describe.
ACTION PLAN
20) A process is in place to develop an action plan that addresses all six Areas of Public Health Responsibility
and local priorities by December 31, 2009.
•
•
54 entities responded yes (70%)
23 entities responded no (30%)
DATA, COMMUNICATION AND RESEARCH INFORMATION
21) The public health department proactively provided information to the public regarding local public health
data for the local jurisdiction. (for example, send out information, such as press releases, fact sheets, score
cards, posted information on website)
•
•
67 entities responded yes (87%)
10 entities responded no (13%)
22) The public health department responded to requests by the public for local public health data. (for example,
community assessment data, county health profile data)
•
•
74 entities responded yes (96%)
3 entities responded no (4%)
23) The public health department has trained, designated staff to provide risk communication to the public
about real or perceived public health concerns.
•
•
74 entities responded yes (96%)
3 entities responded no (4%)
Staff trained and designated to
provide risk communication
1
2
3
4
5
6
9
20
Draft June 22, 2006
Number of entities
that responded
8
36
13
8
4
2
2
1
5
24) The public health department provided risk communication to the public about real or perceived public
health concerns.
•
•
60 entities responded yes (78%)
17 entities responded no (22%)
Risk communication topics
influenza/avian flu
west nile
pertussis
radon
meth
emergency preparedness
contaminated water/land
lyme disease
tobacco
mold
food safety
head lice
Katrina survivors locally
lead
meningitis
polio
TB
tick borne disease
vaccine preventable disease
LaCrosse encephalitis
measles
obesity
rabies
water quality/protection
cancer
disease outbreaks
drug prevention
drunk driving
flooding
heat stroke
Hep B
immunizations
injury prevention
mosquito borne disease
refugees
restaurant inspections
salmonella
shigella
STIs
violence prevention
weather related issues
Draft June 22, 2006
Number of entities
that responded
39
19
13
13
12
11
8
7
7
4
3
3
3
3
3
3
3
3
3
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
6
Risk communication topics
illnesses spread through lack of
personal hygiene
ECHO tapes
Number of entities
that responded
1
1
25) The public health department has conducted its own and/or has been involved with research directed by a
university or other research-type organization.
•
•
24 entities responded yes (31%)
53 entities responded no (69%)
CHB/County/City
Aitkin
Anoka
Bloomington
Carver
Clay
Dakota
Freeborn
Goodhue
Hennepin
Houston
Isanti
Itasca
Lake
Lincoln Lyon
Murray Pipestone
Minneapolis
Olmsted
Otter Tail
Redwood Renville
Richfield
Draft June 22, 2006
Type of research
Focus groups in CTC
Student design survey
South Vista Repeat Pregnancy Prevention Project
Minnesota Partnership for Action Against Tobacco (MPAAT)
developmental CARA grant titled, "A County-Wide Approach to
Worksite Smoking Cessation", in partnership with the University of
Minnesota
Pre & post smoking ordinance data
Project Northland; Water Quality; Dakota Healthy Families; Nurse
Residency project (HRSA grant with U of M)
Clinical Nurse Practitioner students from Minnesota State University,
Mankato, conducted an evaluation project to determine the effectiveness
of the "Baby Think It Over Dolls" program.
Sponsored 12 University of Minnesota nursing students' research on a
variety of community issues
Shape Survey
Meade Movement
Active Living By Design survey
Invest Early, Bridge to Health
MDH - Immunization Information. Obesity - Arrowhead Regional
Development Commission
Two of the four counties that our agency serves are in the National
Children's Study. South Dakota State University (SDSU) is directing
some major research for this project and has contacted us for data and to
be a part of their work. We receive regular updates on the progress of this
major study.
Smoking ban impact study, Seen on da Streets program measures STI,
TCHS measure birth outcomes, Lead project analyzes blood lead levels,
Northside housing impact study, New Families Center evaluating health
care for immigrants
Smoke-Free issues - joint survey with U of MN; Health Care Access joint with Mayo Clinic; Chronic Care Management - joint with Mayo &
other collaborative members
Fourth National Incidence Study of Child Abuse and Neglect
La Crosse encephalitis and eastern treehole mosquito (Oc. triseriatus) on
farm grove sites and mosquito pools
South Vista Repeat Pregnancy Prevention Project
7
CHB/County/City Type of research
Using lead techniques to improve in-home environments to reduce
St. Paul-Ramsey
asthma triggers in homes with persons with asthma.
Cooperated with the local school district and the U of M for a flu mist
Stearns
study in early 2005
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
Env. Health longitudinal study
Project with the University of Minnesota to measure outcomes of public
health nursing home visiting services. Groundwater and surface water
Washington
quality studies in South Washington County.
Wilkin
Pre & post smoking ordinance data
SOCIAL CONDITIONS AND CULTURAL COMPETENCE
26) Describe a collaboration that the public health department and community organizations participated on that
worked to improve social conditions that affect health.
CHB/County/City Collaboration to improve social conditions that affect health
Attended the Poverty Study Circles held in Aitkin in the fall of 2005. The
study circles were made possible by the Northwest Area Foundation,
University of MN Extension and the Aitkin County Homeless Coalition.
Interested community member and person working in or providing
service in the community attended. Community education, empowerment
of women, financial / rental education in school, counselors /mentors in
school and affordable rental housing were identified as action areas.
Action teams involve with the first three areas have met since the study
Aitkin
circles.
Anoka
Mental Wellness Campaign, Family Children's Council
Becker
worked with the community action council regarding dental health;
Spear headed grass roots community efforts to address access to dental
Beltrami
care for those on public assistance programs.
Benton/Stearns Meth Coalition was formed with guidance from the
Benton
Initiative Foundation.
We participate on a Violence Prevention Coalition with the school
district, law enforcement, probation, The Children's Project (children’s
Blue Earth
mental health), YMCA, and business leaders.
Brown
Community meth task force
Carlton
Birth Through Five Family Resource Team
Draft June 22, 2006
8
CHB/County/City Collaboration to improve social conditions that affect health
Carver
Cass
Chisago
Clay
Cook
Cottonwood
Jackson
Crow Wing
Dakota
Draft June 22, 2006
Carver County Public Health (CCPH), Scott County Human Services,
CAP, St. Mary s Health Clinics, St. Francis Regional Medical Center,
Park Nicollet Clinic Shakopee, and Allina Medical Clinic
Shakopee, as part of the Scott/Carver Healthy Communities
Collaborative, worked together to design and open the River Valley
Nursing Center (RVNC). The need was identified in early 2003 after
budget cutbacks in social service and public health programs contributed
to a lack of options for uninsured and under-insured residents from
culturally diverse populations. RVNC opened in April of 2005 and
during its first year received the Benedictine Spirit Award from the
Benedictine Health System and completed the legal work to become
designated as a non-profit charitable organization. CCPH continues to
support the River Valley Nursing Center by participating on the Board of
Directors, providing funding, and sharing resources.
Cass County/Leech Lake Reservation Children's Initiative,
Methamphetamine Coalition, Health Care Task Force
The Chisago County Tobacco Coalition has been functional for a number
of years and has worked on the original tobacco ordinance and continues
to work towards smoke free work places and homes
Advisory committee for dental access, MSCTC dental program advisory
board, dental access board of directors.
Follow Along
Circles of Support works with families to mentor and guide by
surrounding a family with professional that assist that family on using
community resources and teaching. Families meet weekly with Circle
staff and their circle group when needed but at least monthly. The
Elizabeth House an organization that serves both Cottonwood and
Jackson young families and single mothers that have multiple obstacles
in their lives. The Elizabeth House offers Day care, Life Skills classes, a
crisis pregnancy resource center, and a class called "The Bottom Line for
Parents" to teaching sexuality to children by parents. Meetings occur
weekly. Circles of Support is a group of businesses, nonprofit institutions
and faith-based organizations along with individuals in both Cottonwood
and Jackson County. Members of these groups surround a family and
focuses on breaking the cycle of poverty in the communities by focusing
on neighbor helping neighbor. Family Service Network in both
Cottonwood and Jackson Counties provide and reach out to other
community organization that a family need to improve a social condition
that may be having a negative impact on an individual or family.
Tobacco-Free Community Coalition, Medical Community, Law
Enforcement, Initiative Foundation, United Way, Inter-county Depts.,
Meth Coalition & Passenger Safety Coalition
Homeless Committee of the Community Services Division (collaboration
with HRA, the Affordable Housing Coalition, and the Dakota County
Community Development Agency completed a study and report on
homelessness in June 2005. This group was instrumental in promoting a
Metro County Long-Term Homelessness Support Services program.
9
CHB/County/City Collaboration to improve social conditions that affect health
1)Building Connections: a county-wide early childhood initiative
2)Region IV South Adult Mental Health Initiative 3)Northern
Connections, a regional interagency group to address self-sufficiency
following termination from the MFIP program 4)Family Economic
Success program through regional collaboration with West Central
Douglas
Initiative Fund
Community Health Committee surveyed local nonprofit service
providers to determine services available and how they are being
delivered to those in need.
Edina
The Family Services Collaborative funds intensive home visiting,
individual needs (Ritalin, lice treatment, etc.), teen pregnancy prevention
Faribault Martin
(DADS).
Worked with the Sheriff's Department, Highway Department and area
schools on the Safe Communities Grant to improve seatbelt/car seat
Fillmore
usage.
Public Health is a member of the Freeborn County Family Service
Collaborative. The Collaborative supports three programs: 1) Healthy
Families, a Home Visiting program supported by Public Health, Albert
Lea Early Childhood Family Education (ECFE) and Albert Lea Medical
Center; 2) the Behavioral Specialist program, an early intervention
initiative to deal with child behavior problems; and 3) Even Start, a
Freeborn
family literacy program.
We have been collaborating with the Faith in Action - Central Goodhue
County on improving better transportation for county residents in the
Goodhue
greater county to medical appointments.
Community Prevention Coalition of Hennepin County: Founded in 1990,
the Community Prevention Coalition (CPC) is a partnership of local
organizations that share a concern over health risk behaviors by youth in
Hennepin County. CEIP staffs the CPC. The CPC exists to promote
healthy youth development and reduce alcohol, tobacco and other drug
problems in the county. The CPC Partnership Council meets regularly to
share information and plan events. The CPC hosts the quarterly
Prevention Forum to educate community members about important youth
Hennepin
health issues.
Partnership with Human Services, Houston County Women's Resources,
& June Kjome Place Transitional Housing to coordinate services to
TANF population. Financial Fitness for Life educational program
targeting youth was a successful collaboration among LPH, financial
Houston
institutions, schools, and human services.
Community Benefit programming for the poor Access to dental care;
Hubbard
outreach to the uninsured
The Early Childhood Coalition worked with local Optometrists and
Audiologists to assure every pre K child has a comprehensive exam
regardless of insurance status. The coalition also is working with local
Dentist for a similar program. They were able to get 2 Dentist to
Isanti
participate in "Give a Kid a Smile" day
Itasca
Invest Early, Circle of Support, Plant to Plate
Coalition on meth prevention, coalition that addresses teenage pregnancy
prevention, and the Family Services Collaborative that addresses
Kanabec
families.
Draft June 22, 2006
10
CHB/County/City Collaboration to improve social conditions that affect health
Domestic Violence Prevention Workgroup, Child Abuse Prevention
Council, East African Coalition Board Member, Kandiyohi County Teen
Pregnancy Prevention Coalition, West Central Integration Collaborative
Kandiyohi
Board Member
Koochiching
Extension nutrition educator, Circles of Support, Parenting
Lake
Smoking in Public Places; Obesity; Fall and Injury Prevention
LeSueur County Family Services Collaborative: includes Public Health,
LeSueur
DHS, Schools, Court Services
Mahnomen County Children’s Collaborative, Child Protection Team,
Mahnomen
Pregnancy Prevention, Suicide Meeting
Prime West Health System, a county based purchasing project for
provision of health care services for persons on public health care
McLeod
programs, Nurse/Family Partnership and Healthy Senior Options.
Meeker
Mille Lacs
Minneapolis
Morrison
Mower
Norman
Olmsted
Otter Tail
Pennington
Pine
Polk
Pope
Red Lake
Redwood Renville
Rice
Draft June 22, 2006
Prime West Health System, a county based purchasing project for
provision of health care services for persons on public health care
programs, Nurse/Family Partnership and Healthy Senior Options.
Prenatal Project of Prairie Regional Health Alliance.
Meth, and alcohol policies and procedures.
Northside housing fund, health impact assessment
Healthy Communities Collaborative of Morrison County
Tobacco Prevention, Family Services Collaborative, Chemical Health
Coalition, Early Childhood Family Education, Early Childhood
Initiative, Meth Task Force
Norman County Children's Collaborative, Child Protection Team
Families at risk
Health Care Access Task Force
West Central MN Initiative Fund - Annie B Casey Family and Economic
Success Project
Fitness Fever- - encouraged physical activity in our community youth
Worked with Children and Families Services Collaborative, and Area
Agency on Aging
Meth Task Force: attended by Public Health, Law Enforcement, Social
Services, Probation, Environmental Services, County Attorney
Borders united: 8 County Smoke Free Air Initiative. Public Health,
community organizations, youth working on education regarding second
hand smoke and on assessment regarding readiness for ordinance work
Red Lake Co Health Promotion Coalition - ongoing community wellness
Fitness Fever - encourage physical activity in our community youth Safe
Schools - encourage safe & healthy learning environment
Early Childhood Initiative-partner with school, business, probation,
human services, parents for 0-5 activities; Meth internal department
partnering and external partnering with PACT 4, schools, faith
community, human services provides resources for teaching, PSA's,
hotline number, etc.
Rice County Public Health is an active part of a coalition in Rice County
that has established a free clinic and medication assistance program for
un and under-insured Rice County residents.
11
CHB/County/City Collaboration to improve social conditions that affect health
Long-Term CareSummit Child Abuse Prevention Collaborative Clinic
Managers Collaborative Early Childhood Development Nursing Center
Dental Clinic Healthy Communities Collaborative Meth Task Force
Scott
Mental Health/Chemical Health Task Force
Sherburne
Senior Dining Site Board
Sibley County is a part of South Country Health Alliance, a county based
purchasing project to provide health care services to persons on
Sibley
Minnesota public health care programs.
Worked with community partners, including three Reservations to create
a proposal for the Northeast Minnesota Project to end long-term
St. Louis
homelessness, submitted to the Department of Human Services.
A collaboration between public health and Health Care for the Homeless.
Provides health and social services to families living in high-risk
environments, who are at risk for becoming homeless. Homeless
prevention services, home visits, assistance with utility bills,
transportation for medical visits, referrals and follow-ups provided by
St. Paul-Ramsey
staff.
Worked in collaboration with Benton County, City of St Cloud,
Salvation Army, Veterans Administration, Place of Hope Ministries,
Catholic Charities, Housing Coalition of the St Cloud Area, MidMinnesota Family Practice Center, and other providers in putting
Stearns
together a Health Care for the Homeless Grant application.
Steele Dodge
Stevens Grant
Traverse
Todd
Wadena
Wasbasha
Waseca
Washington
Draft June 22, 2006
Dodge Co. PH is part of a Family Services Collaborative that supports
many other programs/org.in the community, such as Big Brothers/Big
Sisters. Steele Co. PH is part of a Children's Mental Health Collaborative
that has supported CD counselors and SW in the schools, ASQ-SE used
at all preschool screenings, First Step program for preschool and K,
wraparound and level 4 setting.
PRIMEWEST - COUNTY BASED PURCHASING
Suicide Prevention, Todd County Citizens Against Drugs Task Force
(meth and drug use) Violence in Youth in Long Prairie Area Committee,
Violence & Injury Prevention in Todd County Youth, Todd Wadena
Healthy Connections Car Seat Program, Senior Citizen falls screening.
Family Service Collaborative-First Years, Youth Assets, Youth At Risk
Todd Wadena Healthy Connections (Coop of hospitals, medical clinics,
Public Health)-uninsured care and child car seats
Family Services Collaborative has been a primary focus for Public
Health collaboration with over 20 agencies throughout the county being
members. Public Health participates in all 3 task forces of this group as
well as being one of the 6 members of the executive board. Collaborative
has helped each school district place a full time social worker, a part time
mental health counselor, a universal home visiting program, a substance
abuse prevention program for teens, and many other worthwhile projects
Waseca County Lunch Bunch Group; Waseca County Collaborative
The department is a member of the Community Health Action Team
(CHAT), which is led by Lakeview Hospital, and has initiated a program
with Portico Healthnet to provide medical coverage for the uninsured.
Lakeview has also established a prescription drug program and a parish
12
CHB/County/City Collaboration to improve social conditions that affect health
nurse program for the St. Croix Valley area.
Watonwan
Winona
Wilkin
The Health Educator provides education to employees of local major
industries monthly.
Winona Co. CHS Dept. Family Health PHN Nursing Director chaired the
Winona County Family Services Collaborative, which has 15 agencies
on the Board including all public schools, and County Human Services,
to support gaps for children and families. In 2005 the reduction in federal
funding forced the FC Board to reduce services by 50 percent, thus the
public health objective to maintain prevention services was primary. The
outcome did move the Countywide Baby Connections service into the
Winona Area Public School system to maintain the basic outreach to all
new mothers and their newborn. Cultural competency is also a goal of
the Family Collaborative and the services it funds. Baby Connections
also strives to achieve this goal and language interpreters are used if
needed.
Advisory committee for dental access, MSCTC dental program advisory
board, dental access board of directors.
27) Administrator/Director and management staff reviewed the Culturally and Linguistically Appropriate
Services (CLAS) standards.
•
•
32 entities responded yes (42%)
45 entities responded no (58%)
28) The public health department successfully hired staff who reflect the cultural and ethnic community served
(excluding Caucasians).
•
•
•
21 entities responded yes (27%)
11 entities responded no (14%)
45 entities responded communities served are almost entirely Caucasian (58%)
How local public health department hired staff who reflect the
CHB/County/City cultural and ethnic community served
Anoka
Anoka County Equal Employment Opportunity Policy
Successfully hired a bilingual nutritionist who was born and raised in
Bloomington
Tanzania
When we added 3 positions for MSHO we made an effort to recruit
bilingual and bicultural staff, mostly through community networking.
The result was one Somali Care Coordinator, and one Latina Care
Blue Earth
Coordinator.
Cottonwood
We do have 2 staff members that speak fluent Spanish at this time,
Jackson
neither are licensed professional.
The percentage of public health work force who represent
racial/ethnically diverse communities increase from 2% to 6% over a
three year period. Successfully utilized the diversity intern trainee
Dakota
program.
Edina
Contracted Bloomington Staff hired a bilingual nutritionist.
Draft June 22, 2006
13
How local public health department hired staff who reflect the
CHB/County/City cultural and ethnic community served
Freeborn
Hennepin
Hubbard
Kandiyohi
McLeod
Meeker
Minneapolis
Olmsted
Rice
Richfield
Scott
Sibley
St. Paul-Ramsey
Stearns
Steele Dodge
Draft June 22, 2006
Hired a bilingual/bicultural Home Visitor, a paraprofessional for the
Healthy Families Home Visiting program.
The Public Health Department recruited staff from cultural communities
by advertising in community papers, sending position announcements out
to community organizations and listserves and by actively hiring
bilingual staff who have an understanding not only of the languages
spoken, but also of the cultural practices and beliefs within the
community.
Spanish speaking WIC staff
2 Latino bilingual staff, 1 Caucasian bilingual staff member
(English/Spanish), end of '05 finalized contractual language for Somali
Outreach staff for 2006 with the West Central Integration Collaborative
Have bilingual nurses and a Hispanic Outreach Worker.
Some of the nursing staff are bilingual in English and Spanish.
Most effective is word of mouth via partners. Department focuses
heavily on community engagement, and connections are critical for
recruitment.
We have staff representing Hispanic, Somali, African-American,
Cambodian, Sudanese, Vietnamese cultures.
Rice County Public Health currently employs one paraprofessional and
one professional staff person who are bilingual in Spanish and English.
Both employees work in the area of maternal and child health, which is
the program area that serves the most diverse client population. Rice
County Public Health also contracts for interpreter services and
purchases language line services.
Successfully hired a bilingual nutritionist who was born and raised in
Tanzania
Russian Consultant-C&TC Outreach Hispanic Case Aid
Sibley County has hired a Hispanic clerical staff person.
Intentionally working to hire staff who reflect the cultural and ethnic
community. October 2005 completed an assessment of staff for cultural
and ethnic employees. WIC Program: Very aggressive recruiting and
working a large network of community contacts. Working with
Human resources to create a trainee position in order to bring in more
employees that reflect the community.
According to the MDH 2005 Minnesota County Health Tables, Stearns
County is 95.5% White, 1.5% Black/African American, 0.3% American
Indian, 1.9% Asian, and 0.9% Two or More Races. Stearns County also
has a 1.7% Hispanic population. Stearns County Human Services/Public
Health Division has one Hispanic and one Asian staff member out of 39
staff. Job Postings are sent to all County Employees, the College of St
Benedict, St Cloud Legal Services, Ridgewater Community College, St
Cloud State University (SCSU), SCSU Multicultural Student Services,
and St John s University. There is also a bonus offered for Public
Health Nurses.
Actually, yes and no. We are able to contract with appropriate
interpreters, have hired paraprofessionals and bilingual Caucasian staff
but have not been able to hire professionals from ethnic communities.
14
How local public health department hired staff who reflect the
CHB/County/City cultural and ethnic community served
Hired prior to 2005 a full time bilingual Spanish speaking PHN and a
Todd
part time WIC Clerk/translator.
The department has trained personnel (CLAS) to provide interpreting and
Watonwan
translating.
Winona
One Hmong Home Health Aide
29) The public health department built cultural competence in current staff.
•
•
52 entities responded yes (68%)
25 entities responded no (32%)
CHB/County/City
Aitkin
Anoka
Becker
Bloomington
Blue Earth
Carver
Cass
Chisago
Clearwater
Cottonwood
Jackson
Dakota
Edina
Faribault Martin
Draft June 22, 2006
How local public health department built cultural competence in
staff
Cultural competency and PH staff reviewed
Cultural competence training and awareness activities presented at staff
meetings and supervisor trainings. There were also several county
sponsored trainings and activities offered to all staff throughout the
year.
staff mainly has interaction with the native American populations and
nurses have had training in terms of positive Indian parenting;
Staff attendance at continuing education sessions on cultural
competency
We participate on our communities Diversity Council. Staff also
participated in diversity training sponsored by the Ethnic Council. We
also serve on the steering committee for the CHW program, and have
been a clinical site for CHW students. We have been making an effort to
include discussions of diverse communities in our programs, and have
been working with both the Diversity Council and the Ethnic Council.
A portion of staff attended multiple trainings including, Building
Community in the Midst of Diversity at the 2005 CHS conference,
Somali Mental Health, and Health Care System Navigation for the
Culturally Diverse.
Public Health Nurse orientation
In-service education for staff
Encouraged cultural diversity in nursing education CEU's.
In-service and classes on cultural diversity or self education of staff as
to culture of a population we may serve.
Updated public health department's LEP plan. Began process to update
department's diversity plan. Updated department's diversity website.
Staff training. Articles in department newsletter. Built diversity goals
into individual staff development plans.
Environmental Health Staff provided educational materials in Spanish
on Food Code and also Food Workers Emergency Preparedness.
Regular review of Limited English Proficiency plan and annual cultural
diversity training.
15
CHB/County/City
Fillmore
Freeborn
Goodhue
Hennepin
Hubbard
Isanti
Itasca
Kandiyohi
Koochiching
Lake
Mahnomen
McLeod
Meeker
Minneapolis
Morrison
Mower
Nicollet
Norman
Olmsted
Otter Tail
Polk
Draft June 22, 2006
How local public health department built cultural competence in
staff
Work with nurses to interact appropriately with our large Amish
community. We limit the number of nurses assigned to go to the Amish
areas and teach the other nurses the norms and customs for the
community.
Arranged an in-service for the Healthy Families home visiting staff
regarding cultural norms for the Hispanic population taught by a
bilingual/bicultural member of the community.
Trained staff in use of AT&T Language Line Offered staff Spanish
language classes
The Local Public Health Department built cultural competence among
staff through Hennepin County sponsored educational offerings that
focused on cultural communities, support for conferences and outside
training on cultural competence and cultural communities, through staff
in-service training and through collaborative relationships with cultural
communities throughout Hennepin County.
In-service
WIC program has done training with their staff. Language line is
available for all staff to use
Native Am Training with Human Service staff
2 staff members attended the multiple series with other community
members through Center for Cross Cultural Health called "Skills to
Action"
Educational surveys, Headstart - Native Am, Introduction to Echo
Awareness of the different European ethnicities is taken into account.
Cultural poverty
Cultural Competency Training and Evaluation
Staff have received training on cultural competence. Use of language
line and interpreters for non-English speaking persons. All programs
incorporate cultural competence.
Staff have received training on cultural competence. Use of language
line and interpreters for non-English speaking persons. All programs
incorporate cultural competence.
1. Conferences/multiple staff. 2. City provide monthly orientation to
various cultures. 3. Motivational, educational, entertainment (MEE)
training on communication with people of color - multiple staff.
One employee took a Spanish class. Developed a Spanish packet for
MCH clients. More work with interpreters.
Staff meeting with representatives from area Welcome Center (Spanish
Center). Receive notices of area speakers on cultural issues.
attend workshops - ECHO
Cultural Competency Training and Evaluation
We use local and state resources for staff training.
Resource Material was available on cultural health issues for special
populations in our county
We have had cultural in-services during monthly staff meetings. We
had 2 women from the Russian Community speak at our staff meeting
about their
16
CHB/County/City
Pope
Redwood Renville
Rice
Richfield
Roseau
Scott
Sibley
St. Louis
St. Paul-Ramsey
Stearns
Steele Dodge
Stevens Grant
Traverse
Todd
Wasbasha
Washington
Watonwan
Winona
Draft June 22, 2006
How local public health department built cultural competence in
staff
Activity was limited Obtained bilingual materials
Worked with Interpreters on cultural issues and have Spanish interpreter
on staff
Has provided education regarding the cultures of the clients with whom
we work.
Staff attendance at continuing education sessions on cultural
competency
Competency Education of Laotian & Native American Cultures
Cultural presentations at staff meetings Participation in ECHO project
Hiring staff of other cultures
Staff have received training on cultural competence. Use of language
line and interpreters for non English speaking persons. All programs
incorporate cultural competence.
Mandatory annual cultural diversity training is required by all staff.
Cultural competency plans are written in all grants.
Offered workshops; attend training. Tapping into knowledge of diverse
staff. Have Hmong Coalition Group and Bienestar Latino Spanish
Group. International Team Clearly defined process for all staff on how
to access interpreter services.
Stearns County Human Services/Public Health Division is continually
in the process of building cultural competence of current staff. There are
policies and procedures that have been developed for the Limited
English Proficiency Plan for assisting the consumers who need
assistance with the English language. There is required annual training
for all Human Services staff as well as other outside opportunities that
staff attend for which the County pays.
Frequent training and encouraged and/or assigned to work with different
groups/org/boards that deal with cultural issues and diversity.
OBTAINED BILINGUAL MATERIALS
Amish culture/philosophies. Staff heritage awareness at an all staff
meeting.
Staff who work in the MCH field have attended workshops on the
Hispanic culture, beliefs, and parenting beliefs.
Public health nurses attended training on Hmong and other cultural
groups. Staff has attended training to increase cultural competence and
information has been shared with other staff. Staff has worked closely
with the TB refugee section of MDH and networking and resources
have been shared. The network of available Interpreters has been
increased and utilized in our work with clients of different cultures.
Staff have attended workshops addressing health care for other cultures.
The Community Health Board maintains a contract with Project FINE,
the local medical interpreter pool and agency for training on cultural
competency. Members of the agency serve on several CHS taskforces
and on the Advisory Committee to provide information and action items
to improve our public health practice.
17
POLICY DEVELOPMENT AND ENFORCEMENT
30) The public health department helped develop significant community and/or legislative policies.
•
•
53 entities responded yes (69%)
24 entities responded no (31%)
Policies developed in six Areas of Public Health
Responsibility
Assure an Adequate Local Public Health Infrastructure
Promote Healthy Communities and Healthy Behaviors
Prevent the Spread of Infectious Disease
Protect Against Environmental Health Hazards
Prepare for and Respond to Disasters, and Assist
Communities in Recovery
Assure the Quality and Accessibility of Health Services
Policies developed
Meth
Tobacco
emergency preparedness
public health nuisance
Tattoo
county based purchasing
health care
MSHO
swimming pools
Administrative
Alcohol
FB&L
food protection
hazardous waste
manufactured home parks
mental health
water quality
Automated External Defibrillator
Camping
care coordination
Dental
EMS
family program
flu vaccine
indoor air
Jail
juvenile curfew
Lead
mass assembly
pedestrian safety
Sanitation
Draft June 22, 2006
Entities that responded
5 (6%)
22 (29%)
11 (14%)
45 (58%)
15 (20%)
12 (16%)
Entities that responded Percent
35
45%
21
27%
14
18%
6
8%
4
5%
3
4%
3
4%
3
4%
3
4%
2
3%
2
3%
2
3%
2
3%
2
3%
2
3%
2
3%
2
3%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
1
1%
18
Policies developed
school wellness
sex oriented business
solid waste
TB
Waivers
WIC
youth camp
Entities that responded Percent
1
1
1
1
1
1
1
1%
1%
1%
1%
1%
1%
1%
31) The public health department conducted enforcement of community and/or legislative policies.
•
•
60 entities responded yes (78%)
17 entities responded no (22%)
Policies enforced in six Areas of Public Health
Responsibility
Assure an Adequate Local Public Health Infrastructure
Promote Healthy Communities and Healthy Behaviors
Prevent the Spread of Infectious Disease
Protect Against Environmental Health Hazards
Prepare for and Respond to Disasters, and Assist
Communities in Recovery
Assure the Quality and Accessibility of Health Services
Policies Enforced
Tobacco
public health nuisance
Meth
FB&L
Campground
manufactured home
Sanitation
swimming pools
Alcohol
Food
solid waste
tattoo
TB
emergency preparedness
hazardous waste
infectious disease reporting
lodging
animal/pest/vector
mass assembly
vulnerable persons
water
well water
administrative
assurances & agreement LPH Act
Draft June 22, 2006
Entities that responded
6 (8%)
27 (35%)
18 (23%)
55 (71%)
3 (4%)
3 (4%)
Entities that responded Percent
34
44%
32
42%
28
36%
11
14%
8
10%
8
10%
6
8%
6
8%
5
6%
4
5%
4
5%
4
5%
4
5%
3
4%
3
4%
3
4%
3
4%
2
3%
2
3%
2
3%
2
3%
2
3%
1
1%
1
1%
19
Policies Enforced
child maltreatment
city of Edina ordinance
delegated agreements
drinking
EMS
home health agency
immunization registry
indoor air
juvenile curfew
MN LPH Act
prenatal exposure
seat belt
services to uninsured
special deputies to issue citations in lieu of
arrest
vending machines
Draft June 22, 2006
Entities that responded Percent
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
1%
20
Summary Analysis of
Promote Healthy Communities and Healthy Behaviors
In the area of Promote Healthy Communities and Healthy Behaviors, all 77 reporting entities (including
counties, cities and multi-counties) did at least one activity/service from the following list of
activities/services*:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Surveillance
Disease and other health
investigation
Outreach
Screening
Case finding
Referral and follow-up
Case management
Delegated functions
Health teaching
Counseling
Consultation
Collaboration
Coalition building
Community organizing
Advocacy
Social marketing
Policy development
Policy enforcement
Definitions for the activities/services can be found at:
http://www.health.state.mn.us/divs/cfh/ophp/resources/docs/ph-interventions_definitions.pdf
The public health department (entity) provided at least one activity/service related to the below
topics:
1. Healthy Aging: 75 entities provided at least one activity/service (97%)
2. Preventing Alcohol Use and Abuse: 76 entities provided at least one activity/service (99%)
3. Arthritis Prevention and Treatment: 55 entities provided at least one activity/service (71%)
4. Asthma Prevention and Treatment: 63 entities provided at least one activity/service (82%)
5. Cancer Prevention and Treatment: 71 entities provided at least one activity/service (92%)
6. Cardiovascular Disease/Stroke Prevention: 74 entities provided at least one activity/service (96%)
7. Diabetes Prevention and Treatment: 74 entities provided at least one activity/service (96%)
8. HIV/AIDS Prevention and Treatment: 67 entities provided at least one activity/service (87%)
9. Injury Prevention: 77 entities provided at least one activity/service (100%)
10. Mental Health: 76 entities provided at least one activity/service (99%)
11. Methamphetamine Use: 72 entities provided at least one activity/service (94%)
12. Nutrition: 77 entities provided at least one activity/service (100%)
13. Other Drug Use: 64 entities provided at least one activity/service (83%)
14. Promoting Physical Activity: 76 entities provided at least one activity/service (99%)
15. Reproductive Health: 76 entities provided at least one activity/service (99%)
16. STDs/STIs Prevention and Treatment: 74 entities provided at least one activity/service (96%)
17. Suicide Prevention: 54 entities provided at least one activity/service (70%)
18. Preventing and Reducing Tobacco Use: 75 entities provided at least one activity/service (97%)
19. Preventing Unintended Pregnancies: 77 entities provided at least one activity/service (100%)
Draft June 22, 2006
1
20. Violence Prevention: 71 entities provided at least one activity/service (92%)
21. Child Growth and Development: 77 entities provided at least one activity/service (100%)
22) If needed, the public health department developed and provided educational services/materials in languages other than
English:
•
•
•
42 entities responded yes (54%)
12 entities responded no (16 %)
23 entities responded not needed (30%)
If yes, list services/materials and languages:
CHB/County/City
Services/materials in other languages
Blue Earth
st Food Iron 1s Baby Your-Breast Milk :WIC Program Educational cards in Spanish
st Food Planning for Solids Starting Baby Foods 1s Your Baby -Fortified Formula
Beginning Finger and Table Foods Happy Birthday Feeding Your Toddler Customer
lth Service Surveys were translated into Spanish, Russian, and Arabic Family Hea
Bosnian, Russian, :1Materials Translated by Anoka County Accessing Health Care Part
Bosnian, Nuer, Russian, :Nuer, Spanish Family Planning :2Accessing Health Care Part
Arabic, Bosnian, Hmong, Laotian, Nuer, Russian, Spanish, :Spanish Feeding Baby
Arabic, Bosnian, Hmong, Laotian, Nuer, :ali, Vietnamese Growth and DevelopmentSom
Arabic, Bosnian, :Russian, Spanish, Somali, Vietnamese Safety for Babies and Children
Proper Hmong, Laotian, Nuer, Russian, Spanish, Somali, Vietnamese Oral Medications
Proper Use and Bosnian, Russian Oral Medications :1Book -d Administration Use an
Family Health Materials Developed by the /Nuer, Spanish C&TC :2Book -Administration
Arabic, Bosnian, :Child and Teen Program Information :Written :MAG Partners and DHS
dna dlihC esemanteiV ,hsinapS ,ilamoS ,naissuR ,omorO ,naitoaL ,gnomH ,Cambodian
14-12mo, 11-9mo, 8-6mo, 5-4mo, 3-1Newborn, Your Growing Child Teen Check Up
yr, Teenager Arabic, Bosnian, 10-7yr, 6-4yr, 3yr, 2mo, 23-18mo, 17-15mo,
otian, Oromo, Russian, Somali, Spanish, Vietnamese Cambodian, Hmong, La
Arabic, Hmong, :Russian, Spanish, Vietnamese Food Pyramid :Tylenol Sheet/Fever
Bosnian, Hmong, Russian, Somali, :Russian, Somoli, Spanish, Vietnamese Immunizations
Cambodian, Hmong, Laotian, Russian, :nRussian, Vietnamese Ready for Kindergarte
Arabic, Somali, :Somali, Spanish Resource Fair Flyers for People with Limited English
:ECHO Child and Teen Checkups and School Health :or Video/Spanish, Russian DVD and
:ntro to Child and Teen Check UpsHmong, Khmer, Lao, Somali, Spanish, Vietnamese I
Family Emergency Preparedness Plans, Severe :Hmong, Somali, Spanish Echo Series
Borne Illnesses, Child -Weather Warnings, West Nile and Lyme Disease, Preventing Food
risis, All About Avian and Teen Checks and School Health, Mental Health During C
Public :Hmong, Khmer, Lao, Somali, Spanish, Vietnamese DPC Bird Flu Influenza or
.Immunization clinic materials in Spanish and Russian
FAP; WIC, nutrition education materials in Spanish
Provided more of our materials in Somali and Spanish. Provide a Spanish speaking nurse
to our Spanish population. Now offer Follow Along Program in Spanish.
In English and Spanish: birth control instructions, 15 separate STD educational pamphlets,
Let's Talk Tins, and Rainbow Parenting brochures
We have been adapting the Immigrant Resource Guide that was developed in the metro
area for use in our community.
Carver
Letters and surveys were developed in Spanish and used in our All Babies Count program,
in which all new mothers in the county are contacted. A resource card was also developed
in Spanish.
Anoka
Becker
Benton
Bloomington
Edina Richfield
Dakota
Faribault Martin
Mantoux information on TB given in the jail in Spanish materials are used as needed for
WIC
Provide info developed by others in numerous languages - no new ones developed
specifically by us
Purchased Child Development Curriculum. Purchased videos on child development
Draft June 22, 2006
2
Cass
CHB/County/City
Goodhue
Hennepin
Kandiyohi
LeSueur
Lincoln Lyon
Murray Pipestone
Mahnomen
Marshall
McLeod
Meeker
Minneapolis
Morrison
Services/materials in other languages
Use of the AT&T Language Line Use of interpreters for working with clients
Health Education materials in Somali, Spanish, Loation, Bosnian, Russian, Hmong,
Vietnamese, Oromo, Amharic,
Prenatal & postpartum education packets available in Spanish
Many of our educational materials are both in English and Spanish, however we did not
develop them - many are from MDH. This agency developed a Spanish "Family Health
Services" brochure and a Post-partum depression brochure in Spanish.
Handouts used for C&TC Outreach, MCH and TANF - "Noodle Soup" publications;
Vaccine information sheets and C&TC Periodicity tables. All these handouts are available
in Spanish, Somali and Hmong
Spanish Materials
Obtained materials in Spanish.
WIC materials, Patient Bill of Rights/Spanish
Healthy pregnancy, family planning, healthy lifestyle, basic parenting resources, ATOD
information and nutrition education materials were either purchased in Spanish or
translated into Spanish.
Community resource materials in Spanish, Somali, and Hmong for New Families Center.
Mower
Spanish letter to WIC clients on appt. MCH packet in Spanish.
Spanish interpreters were provider if needed for all program areas. Forms for the Open
Door, MCH, and school health program were translated into Spanish.
Nicollet
Norman
Consent for persons seeking interpreter services and defining expectations for interpreters
Interpreters and Spanish Materials
Olmsted
Feeding Your Baby - Birth to 4 Months: Vietnamese, Laotian, Somali, Cambodian Feeding
Your Baby - 4 to 6 Months: Vietnamese, Laotian, Somali, Cambodian Feeding Your Baby 6 to 12 Months: Vietnamese, Laotian, Somali, Cambodian Common Health Concerns:
Spanish 2 Month Check-Up: Spanish 4 Month Check-Up: Spanish 6 Month Check-Up:
Spanish 9 Month Check-Up: Spanish 12 Month Check-Up: Spanish 15 Month Check-Up:
Spanish 5 Year Check-Up: Spanish 6-7 Year Check-Up: Spanish Promise to love, Protect,
Vaccinate Them!: Spanish Head Lice Health-Facts for General Use: Spanish, Cambodian
Head Lice for Public Health Nurse Use: Bosnian, Cambodian, Laotian, Somali, Spanish,
Vietnamese Breastfeeding: Cambodian, Hmong, Laotian, Somali, Spanish, Vietnamese
Otter Tail
Had Health Tracks converted into Spanish and have ECHO tapes in various languages
Pine
C&TC Outreach: information on elevated lead levels and check-lists available in Spanish.
WIC: nutritional handouts, information on elevated lead levels in Spanish.
Polk
Redwood
Renville
Spanish brochures. WIC brochures in Spanish and Russian. TB information in Korean.
CTC Hmong/English brochure developed from DHS translations
Scott
All services able to be provided in the language of our clients; in addition to English, the
most frequent languages are Spanish and Somali. Health education materials are routinely
made available materials in Spanish and, less frequently, Somali (less availability).
Examples are materials on child growth and development, brochures from area services
for families experiencing domestic violence, educational pamphlets regarding
immunizations and Tuberculosis, and videotapes/DVDs for in-home use with families with
young children.
List of local Family Planning Recourses in Spanish Family Resource Brochure in Spanish
Parent/Teen Driving Contract in Spanish List of Low Cost Medical Clinics in Spanish List of
Low Cost Dental Clinics in Spanish
Sibley
Public Health routinely provides forms or educational material in Spanish. This material is
used in a variety of programs including: Family Planning, Pregnancy Testing, MCH- home
visits/education, New baby visits (universal contacts), TANF home visiting, WIC program,
Early Childhood Screening, CTC, and various health promotion topics.
Rice
Draft June 22, 2006
3
CHB/County/City
St. Paul-Ramsey
Stearns
Steele Dodge
Stevens Grant
Traverse
Todd
Wasbasha
Washington
Watonwan
Wright
Services/materials in other languages
Videos and download pdfs off Web in Spanish, Hmong, Vietnamese, Ker, Somali, Lao:
Avian Influenza; Isolation and Quarantine; Severe Weather Preps; Nutrition & Exercise;
Safety from Fire and Carbon Monoxide Poisoning, Mass Dispensing of medicine; family
Emergency preparedness; Severe Weather Warnings; West Nile Virus and Lyme Disease;
preventing Food-Borne Illnesses; Child & Teen Check Ups; Mental health Help; All About
the Flu and Pandemic Flu; Winter Preparedness and Safety; Asthma and Respiratory
Diseases; First Aid and CPR. Spanish Brochures: Help Your Child Learn; Failure To
Thrive/ High Calorie Foods; How to Prepare Baby Food; Breast Feeding; Infant Massage;
Weight Gain During Pregnancy; Relaxation and Respiration During Labor. Who Will I
Become video-Hmong You Are Special mirrors- Hmong Peaceful Parenting magnetsSpanish and Hmong Thriving With your Teen brochure- Spanish Peaceful Parenting
posters- Spanish and Hmong Handwashing posters- Hmong Child & Teen Checkups:
1)Child & Teen Program in Video and DVD- Hmong, Somali, Spanish 2) Immunization
Reminder Cards- Hmong, Somali, Spanish 3)Immunization schedule-Hmong, Somali,
Spanish 4) Lead, Immunizations, Nutrition Posters in Somali, Spanish and
Hmong(Nutrition) Vast array of WIC Education Written Materials available in English,
Spanish, Somali and some Hmong. (developed by MN WIC Program)
WIC Rights & Responsibilities: Somali, Spanish; WIC Appointment letter: Somali, Spanish;
Tennessen Notice: Somali, Spanish; Family Home Visiting Program Letters: Somali,
Spanish; and Family Home Visiting Brochure: Somali, Spanish, Lao
MCH,HH and HIPAA Forms, School Readiness Brochures Spanish, Somali, Sudanese
FOLLOW ALONG PROGRAM WIC CTC SPANISH
Child Activities Sheets, Follow Along and CTC Letters, Behavior Management Tools,
Spanish (ie) CTC/DT, Immunizations, Received some brochures from MDH.
Educational materials in MCH areas, disease specific information as needed. Spanish is
the only language developed in
Spanish "Shoulder To Shoulder" materials. Created by Metro region project.
Spanish Brochures
Varied educational information provided primarily for young families in Spanish.
Educational packets for pregnant and parenting Latino community members with
translators, teaching provided to Latino families.
23) If the public health department contributed to achieving a policy/system/environmental change related to Healthy
Communities and Healthy Behaviors (HCHB), describe the change and the department’s contributing efforts.
CHB/County/City
Aitkin
Draft June 22, 2006
Example of policy/system/environmental change
In an effort to increase breastfeeding awareness, and ultimately increase breastfeed
initiation and duration rates, Aitkin County has been an active participant, along with 6
other counties, in the applying for and receiving of a WIC Breastfeeding Peer Counseling
Grant. Breastfeeding Peer Counselors provide basic information about breastfeeding to
WIC mothers during their pregnancy, and after her baby is born. They encourage mother
to breastfeed, and help mother find help if problems occur. The WIC Coordinator
supervises the Breastfeed Peer Counselor. The grant is also allowed for continuing
education for the WIC Coordinator, enabling her to become a Certified Lactation
Counselor. This allows her to also play a more active role in encouraging and supporting
breastfeeding women. As a Certified Lactation Counselor she is an available resource to
not only WIC participants but also to other professionals seeking breastfeeding information
or resources within Aitkin County or possibly the 7 county region. Peer counseling is a
significant factor in improving breastfeeding initiation and duration rates among women,
especially those that are economically disadvantaged and are living in rural locations. As
of December 2005, the WIC Breastfeeding Peer Counselor in Aitkin County had worked on
a one-to-one basis with approximately 40 pregnant or postpartum women. In December
2005, breastfeeding had been initiated with 80% of Aitkin County WIC infants within their
first 3 months of life and 100% of WIC infants had breastfeeding initiated and were still
currently breastfeeding at 3 months of age.
4
CHB/County/City
Example of policy/system/environmental change
Anoka
The Health Department worked with the Anoka County Parks and Recreation Department
and the Anoka County Board of Commissioners to implement a Tobacco Free Parks and
Recreation policy in Anoka County Parks.
Becker
Beltrami
Benton
Bloomington
Blue Earth
Carlton
decrease spread of infectious TB through surveillance and screening; increase the
screening for mental health needs for adolescents, pregnant and pp women; increase % of
children 0-3 who are screened for developmental issues; increase # vaccinated for
influenza; increase # of 2 y/o's immunized; increased participation rate of ma/mc enrolled
kids in the CTC.
Implementation of a county wide smoke-free ordinance for indoor public places and places
of work. Agency involved in policy development and ordinance implementation.
Public Health in collaboration with Social Services, County Attorney, County Administrator,
Sheriff's office and Zoning and Planning developed a protocol for Treatment of Children
found in a Meth environment. This same group developed a Meth/Public Health Nuisance
Ordinance that was adopted by the County Board.
Implementation of the 2004 Smoke-Free Workplace Ordinance: - Signage - Educational
materials - Updated Web site Coordinated internal workgroup that developed series of
reports on initial effects of the Smoke-Free Workplace Ordinance
We participated with the Smoke Free Coalition that developed a smoke free ordinance in
the city of Mankato.
Chisago
Clearwater
Universal: County-wide Preschool Screening: Mental Health Screens Using ASQ:SE
Carver County Public Health (CCPH) has a long history of being present at the Carver
County Fair. Typically this presence is in the form of displays, brochures or other
educational materials. In 2005 CCPH changed the way they worked with the Carver
County Fair and took a more systems level approach. This different approach resulted in
two environmental changes. First, CCPH worked with the Carver County Fair to make its
grounds more hand washing friendly. There is only one bathroom with running water on
the fairgrounds and lack of funding made adding additional running water sinks not
possible. Public Health recommended hand sanitizer stations be installed in the barns,
outside of the restrooms and at other strategic places throughout the grounds. The Carver
County Fair made the change and used CCPH signage to lead fairgoers to these new
facilities. CCPH plans to continue to work with the Caver County Fair in this capacity.
Secondly, CCPH proposed that the Carver County Fair have space available for
breastfeeding mothers. The Carver County Fair agreed, and provided a tent. CCPH then
assisted in the tent layout, advertising and evaluating the tent's success. The tent was a
major success with nursing moms and CCPH is optimistic that the breastfeeding tent will
be made available at the Carver County Fair on an ongoing basis.
The Public Health Division was instrumental in convening the Cass County
Methamphetamine Task Force. Public Health saw the need for coordination and
collaboration, offered staff time and has been essential in bringing the group together. Part
of the mission of that Task Force is public education. Public education will be provided in
coordination with Sheriffs Department and the Environmental department.
The public health department played and continues to play a very active role in the
development of a meth ordinance as well as setting out the processes for working with
other departments in handling a meth lab. The notification system has changed so there is
now a working communication path between all involved departments.
Wellness Committee - invited participant
Cook
Cottonwood
Jackson
Public Health facilitated the process for developing and implementing a Meth Ordinance.
Preventing and Reducing Tobacco use--Restaurants in counties are going smoke free
without ordinances.
Carver
Cass
Dakota
Douglas
Draft June 22, 2006
School Nutrition and Physical Activity Policies in state outcome Increase the levels of
physical activity among youth in 6th, 9th, 12th grades: Dakota County Public Health staff
have provided technical assistance to all school districts in the county to improve their
policies and procedures on physical activity and nutrition. Staff have developed a physical
activity and nutrition assessment tool and co-sponsored a regional training.
Through the Douglas County Safe Communities Coalition we have conducted seat belt
challenges, education, and promotion throughout Douglas County increasing seat belt
usage. Public Health has taken the leadership role with excellent community support.
5
CHB/County/City
Example of policy/system/environmental change
Fillmore
Dialogue to change meth lab ordinance to be more detailed in regards to exposed children
Organized and successfully completed the American Cancer Society's Active for Life
program for County employees.
Hennepin County Smoke Free Ordinance Passed on March 31, 2005. Department staff
conducted research and provided support materials to policy makers
As a member of Active Living By Design Coalition were able to have sidewalk ordinances
passed in all 3 cities in Isanti County
Freeborn
Hennepin
Isanti
Kanabec
Kandiyohi
Koochiching
Lake
LeSueur
Mahnomen
Marshall
McLeod
Meeker
Mille Lacs
Mower
Norman
Olmsted
Otter Tail
Pine
Draft June 22, 2006
The department established a plan for working with the local veterinary clinic in identifying
possible cases of blue-green algae toxicity to educate the public and local lake
associations on the potential risk for animals and people.
In 2005, our Steps School Coordinator worked with Willmar Public Schools Food Service
Director to draft a School Wellness Policy. Willmar's policy became a model/template
policy for school districts and was used across the state. (National case study in 2006)
Advocated for community walking trails, advocated for smoke free parks ordinance,
provided community training / education on Meth use and labs and assisted in developing
county protocol for medical evaluation of children found in drug labs
Obesity Grant Implementation with the Arrowhead Regional Development Commission;
Public Health Advisory Council on Smoking
Public Health successfully worked with county board to adopt the "Cleanup of Clandestine
Drug Lab Sites" ordinance in LeSueur county.
Home Safety Assessments, Infant Mental Health Assessments
Reactivated the Marshall County Interagency Early Intervention Committee. Public Health
was the lead agency.
Instrumental in assisting a community form a coalition to work with their youth
Smoke free workplace ordinance was adopted in Meeker County 07/2005. Public health
provided leadership, community organizing and a broad based education campaign toward
the effort.
meth regulations
Mower Count Public Health was part of a local Methamphetamine task force that was
instrumental in getting a local Meth ordinance in place.
Home Safety Assessments, Infant Mental Health Assessments
Olmsted County Public Health has a tobacco-free restaurant ordinance, meth lab cleanup
ordinance, and a protocol for medical assessment of children exposed to meth labs. The
school district currently has a vending machine contract/policy that promotes non-soda
beverage consumption -- all of these were developed before 2005. The Olmsted County
Board adopted a resolution supporting state and federal legislative action on restricting
meth precursor sales which resulted in the MN state law in 2005. There is an "informal"
policy regarding ASQ SE being administered to all children in PSS in Olmsted County.
We currently work with 4 out of the 8 schools in our county on their Wellness Policies
16. Increase the screening for mental health needs for adolescents, children with special
health needs, and pregnant and postpartum women. Pine Co. Public Health has been
working with Children's Mental Health at a county level to develop a team strategy for the
screening of children with mental health diagnoses and problems. Screenings are
conducted along with our school contact on referrals that are received. The tool used is the
ASQ-SE, which has helped to identify an increased number of children with
social/emotional problems before they are even diagnosed. In addition, our MCH nurse
has been performing screenings for depression during postpartum visits, and following up
with counseling, either through Public Health or referral to an outside source. 18. Increase
the percentage of children ages 0-3 who are screened for developmental and social
emotional issues every 4-6 months. The Infant Follow Along program has more than
doubled in numbers of referrals within the past year. This is due to a concerted effort of our
WIC staff in making the referrals, and our IFAP Coordinator following up on these efforts.
As a result, we have also identified more children with special needs that will receive
services from the school system, public health, and/or other therapeutic providers.
6
CHB/County/City
Polk
Pope
Rice
Scott
St. Louis
St. Paul-Ramsey
Stearns
Steele Dodge
Stevens Grant
Traverse
Swift Big Stone
Chippewa Lac
Qui Parle Yellow
Medicine
Wadena
Wasbasha
Waseca
Draft June 22, 2006
Example of policy/system/environmental change
New policies on Orasure HIV testing provided in our agency. Collaboration with RAAN.
New car seat education program. Collaboration with Safe Kids. Safe Schools II activities in
2 school districts. Collaboration with Northwest Mental Health and schools.
Children’s Mental Health: Implementation of ASQSE through FAP and Implementation of
PECFAS screening at CTC/ECS followed by Public Health doing full PECGAS for
appropriate children and referring them to Mental Health Providers
Rice County Public Health collaborated with other county departments to draft a
clandestine laboratory ordinance, which was adopted by the Board of Commissioners, and
took the lead in developing a guideline for the follow-up of children found at a clandestine
laboratory site.
Methamphetamine County Ordinance
Public Health Nurses collaborated with the Northland Interagency Intervention Committee
(combined IEIC & CTIC) and the Mesabi Interagency Early Intervention Committee in the
First Signs Project, a national/state initiative to increase awareness among the medical
community about the need for earlier identification of children with mental health problems,
specifically autism.
Standardized process for Assessments of MFIP clients where developed; The Department
developed the process, created the recording form and communication process, and
implemented the change. This had an impact on the functioning of multidepartmental staff
in the MFIP Teen Parent Program (Assessment of Living Arrangement) and the MFIP
Extension Services Unit (Health Assessment)¿ Wakenhaza Project has achieved
policy/system/environmental change in MN Children s Museum, libraries, clinics and
shelters across Ramsey County & the State. Wakenhasa Project was developed by
SPRCDPH.¿ Tobacco reduction, tobacco ban in restaurants supported St. Paul Schools in
doing school. Health index and in developing wellness policy. Tobacco work with
Ramsey Tobacco Coalition on smoke-free parks and public places advocacy for smokefree ordinances.
Stearns County Human Services/Public Health Division was responsible for the
development and presentation of county-wide methamphetamine guidelines for community
providers pertaining to children, pregnant women, and methamphetamine production
environments. The guidelines were approved by the Stearns County Board in 2005.
Meth. Cleanup ordinance in both Dodge and Steele Co. Smokefree Restaurants in both
counties.
BORDERS UNITED/SMOKE FREE AIR
Fetal Alcohol working with clinics, communities, businesses. Prenatal project with clinics
and public health
Coordinated childhood screening including assessment and planning for universal
developmental screening. Public Health was the lead in this effort.
Smoke free workplace including grounds was implemented for 2 of our larger employers.
County adopted a smoke free workplace policy and grounds are all smoke free and
employees not allowed to smoke on paid worktime which includes paid coffee breaks.
Public Health staff very involved in assisting the employers in policy development,
education to employees, and assist in locating smoking cessation resources for employees
who wished to cease smoking.
Policy and system change - Development of the methamphetamine ordinance regarding
clean-up of clandestine labs in Waseca County. The change is that there was no
ordinance to address clean-up of labs in the county. Public Health developed policies and
procedures for tracking and assuring the remediation of the site. Public Health also
developed the Meth Task Force. The task force consists of community leaders from law
enforcement, court administration, public health, human services, and fire department and
other first responders.
7
CHB/County/City
Washington
Winona
Example of policy/system/environmental change
The department has facilitated the development of a county wide school-based chemical
health service system which is comprehensive, and coordinated to reflect best practices.
The goals of the system are to reduce student chemical use and improve educational
performance. These efforts over the past three years have demonstrated system changes
and will continue to influence school chemical health policy change. Public Health
continues to play a role with coordination of the service and education programs.
The Winona Co. CHS staff (Adm & MCH Directors) and EH Director initiated the
community partners Committee to provide the County Board via Winona County Human
Services, a protocol for Children Found at Methamphetamine Lab Sites. This was adopted
in 2005 in accordance with the Winona County Methamphetamine Ordinance.
24) Describe a new or existing group that the public health department convened, joined or partnered with that was
considered successful. State the name of group, the HCHB outcome worked on (if applicable), the department’s role on
the group, the intervention(s) the group worked on, and a description of the activities of the group. Describe the results, if
any. (Use a group different from the one mentioned in question 23.)
CHB/County/City
Aitkin
Anoka
Draft June 22, 2006
Group that was considered successful
During 2005, Public Health conducted a Fat and Surgar booth at the McGregor School
Fair. The booth displayed items from the school vending machines, along with their fat
and sugar content. The booth was a success. Shortly thereafter, McGregor School
reduced the amount of pop available in their vending machines. Water is now the #1
seller. The booth was transformed and displayed as part of the County Fair and used at
Aitkin High School and Mc Gregor School 7th grade open houses, and at the Rippleside
and Hill City school open houses. Because of the awareness this booth raised, the
school nurses and public health staff agreed to meet on an ongoing basis to work on
school health issues. The first issue they intended to address was nutrition. Ultimately,
each school invited Public Health to work on the school wellness policies that they were
mandated to have completed by July 2006. Each of the wellness policies will be
presented to the school boards in April or May.
Methamphetamine task force involvement let to a meth treatment grant which will
provide case management services for women with children who are in need of
treatment for meth addiction. School nurses and health care provider clinics have
regular meetings for disease prevention and control issues in those settings and
emergency preparedness. Hurricane Survivors Response Team was formed in
September 2005 to coordinate response services for Hurricane Katrina evacuees. The
team consisted of Human Services Division staff and community partners including
Community Emergency Assistance Program (CEAP), Anoka County Community Action
Program, Free-to-Be, and the Salvation Army. The team coordinated quality services
efficiently to assure that the Hurricane Survivors had their needs met, providing
housing, emergency assistance including food, clothing, money for rent, transportation,
furniture, etc. The survivors were screened for potential health needs and concerns and
linked to the appropriate resources to meet those needs. By October, 40 Hurricane
Survivor households had connected with Anoka County services. The families received
a wide variety of services to meet their needs. Families continued to be followed
through Public Health Nursing, Income Maintenance, and the Jobs and Training Center.
Community partners including the Faith Community continued to assist families.
Families expressed their appreciation for the services they received. The Limited
English Proficiency Plan (LEP) was adopted by Anoka County on May 28, 2002 to
ensure compliance with Title VI of the Civil Rights Act of 1964. An Interdepartmental
LEP Team was formed. The Human Services LEP Teams consists of representatives
from Income Maintenance, Social Services, Community Health and Environmental
Services, Corrections, Jobs Training Center, and Fiscal Services. The Human Services
LEP Team reviews the LEP plan for effectiveness. They meet quarterly to address
problems and issues. Each year they complete an evaluation that includes: 1)
Assessment of the number of persons with LEP in Anoka County, 2) Assessment of
current language needs of applicants and clients, 3) Assessment of whether existing
language assistance is meeting client need, 4) Assessment of staff members
understanding of LEP policies and procedures and how to carry them out, and whether
language assistance resources and arrangements for those resources are still current
8
CHB/County/City
Group that was considered successful
and accessible, 5) Seeking and obtaining feedback from non-English or limited-English
speaking communities in Anoka County.
Becker
obesity coalition
Beltrami County Public Health was responsible for convening at dental access
workgroup. The purpose of the workgroup was to address dental access for under and
uninsured families and children. A community clinic concept is what the plan includes
with extensive community partnerships including the hosting of the clinic at the North
West Technical Institute dental assisting program. It is expected that a community clinic
would be up and running by the fall of 2007.
Benton County began partnering with Stearns County and the Initiative Foundation to
form a Meth Coalition. The Coalition is just in the beginning stages. End of 2005
planned the dates for the Community Focus Groups and planned the Training for the
Coalition members. HCHB: Promoting Healthy Communities Healthy Behaviors
In 2005, an informal group was formed to discuss the increased number of Latino
stillbirths. It developed into the Healthy Latina Pregnancy group, a diverse coalition
including Latino serving organizations, Catholic churches and the Archdiocese, St.
Mary s Clinics, MDH, March of Dimes, SIDS Center, and Local Public Health agencies
from Hennepin, Ramsey and Dakota Counties. Activities included numbers 3, 4, and 8
(as listed in the Essential Local Public Health Activities). Interventions included:
Surveillance, Outreach, Health Teaching, Collaboration, and Coalition building. The
group has reviewed stillbirth and infant mortality data, as well as research regarding
possible causation. On April 22, 2006, Spanish speaking members of the group will
present information to staff from Catholic churches in Hennepin, Ramsey and Dakota
Counties about resources for pregnant women including PHN home visiting, MA, WIC,
medical and dental care as well as some key messages for promoting healthy
pregnancies. New information learned: listeria infection (from Mexican cheese) and folic
acid deficiencies are the leading cause of stillbirth in Texas. Future plans include
continuation of educational sessions to Latino-serving groups and individuals and
finding resources for more research into the issue of Latino stillbirths.
MoFAS - Mn Organization on Fetal Alcohol Syndrome conducted the Pregnant Pause
Event. Focus was to highlight that pregnant women can still go out with friends and
have a good time without consuming alcohol. Bars in town participated with a
competition for the best non-alcoholic beverage. Many of the drinks created for the
event have become permanent additions on their menus.
Family Resource Team; Parent and Infant Mental Health Team for mentally ill parents
with children birth to 5 or children birth to five with social/emotional concerns. DHSInfant Mental Health Grant. A Goal - promote healthy attachment. Resource to families
through multidisciplinary interagency team approach. Collaboration, case finding,
referral and follow-up, consultation, advocacy.
The Carver County Health Partnership (Health Partnership) is a collaborative effort of
local businesses, non profits, community groups, concerned citizens, governments, and
churches working together to make Carver County a healthy place to live and work.
Carver County Public Health (CCPH) actively partners with and participates in the
Health Partnership's work. During 2005 the collaborative focused a lot of its time and
energy on "connections". The collaborative used the Eat. Talk. Connect! campaign to
encourage families to connect with their children, employees to connect with their coworkers and seniors to connect with family and friends. The campaign "challenges"
participants to eat at least three meals a week with their family for three months.
Interventions used in the campaign include: outreach, health teaching, collaboration
and social marketing. CCPH's role in the campaign is to provide funding, participate in
planning and staff committees. The campaign continues into 2006, but currently 5,500
residents are participating in the campaign.
Cass County 0-3 group for the Follow Along Program (FAP). Outcome: Increase the
percentage of children ages 0-3 who are screened for developmental and social
emotional issues every 4-6 months. Public Health s role: Providing FAP universally to
children ages 0-3 years, convening representatives from other early childhood
programs across the county to assist in the enhancement of the social emotional
tracking, to avoid duplication, to increase referrals into the program, and to coordinate
the referral system through out the county for parents.
Beltrami
Benton
Bloomington
Blue Earth
Carlton
Carver
Cass
Draft June 22, 2006
9
CHB/County/City
Chisago
Clearwater
Cook
Cottonwood Jackson
Crow Wing
Group that was considered successful
The Senior Network has addressed outcome # 20 as well as outcome # 35. The public
health department has been one of the leaders of this group which has worked on many
access issues for seniors and their adult children. They have developed presentations
used in the community, a menu of available services, a directory and do a Senior Expo
every year just to list a few of their activities. A social worker has also been made
available to seniors and to pharmacies to deal with the Medicare Part D program.
Children's Mental Health Collaborative - mandated partner - see DHS report
Public Health brought partners together to implement the Follow Along Program in
Cook County.
Jackson County Meth Task Force - Meth Use Jackson County Family Service Network
and Cottonwood County Family Service Collaborative- Injury prevention, Nutrition, Drug
Use, Violence, Child Growth and Development IEIC-- Child Growth and Development
Cottonwood and Jackson Long Term Care Task Force -- Healthy Aging
Passenger Safety Coalition: Collaborated on injury prevention & alcohol-related crash
prevention. PH are the facilitators of this meeting, provided education on child safety &
dangers of drinking/driving. Tobacco-Free Community Coalition: Outcome is to work
towards a tobacco-free community, we facilitate the monthly meetings & build
community partnerships. Provided education to the community & schools primarily on
tobacco use & smoke-free workplaces. Bioterrorism Advisory Committee: Facilitated
meetings, develop &/or update a community -wide emergency plan. Meth Prevention
efforts Committee: Acted in collaboration with community partners & the Initiative
Foundation. Worked to develop a strategic plan on eliminating meth use in Crow Wing
County. All continue to be successful committees.
Edina
Dakota County Public Health staff secured funding and created the Safe Dakota
Coalition, a countywide coalition with partners from 11 city police departments, 12 high
schools, the County Sheriff s Department, county engineer, and County Attorney s
Office. The coalition seeks to reduce traffic crashes, injuries and fatalities by promoting
safe driving, decreasing drinking and driving, increasing use of seat belts, and
improving road design. Fatalities from accident-related crashes in Dakota County
decreased from 33 in 2004 to 24 in 2005. Statewide Outcomes addressed: decrease
the rate of persons killed and injured in motor vehicle crashes; decrease underage
drinking
Douglas County Building Connections - a coalition focusing on children and families has
grown in numbers and support. Through collaboration we accomplished a great deal an extensive community assessment through several focus groups, surveys and
community forums with priorities established for action.
In 2005 Public Health convened two school health groups one in the Edina School
District and the other in Richfield School District. Each of the groups sent a team to a
Physical Activity and Nutrition forum (PAN) developed by a collaborative of metro public
health agencies (Hennepin, Dakota, Ramsey, Minneapolis and Bloomington). The
Richfield group invited Public Health to work on the school wellness policies that they
were mandated to complete by July 2006. Edina School worked with Public Health on
a consulting basis because they were farther along in developing the wellness policy.
Each of the groups developed strong wellness policies, presented them to school board
and they were adopted by the district.
Fillmore
Safe Communities Coalition - Decrease traffic crashes and related fatalities, lead
agency, partnering with engineers, law enforcement, EMS, schools, care providers, etc.
Seatbelt challenges with schools, training for care providers, training at driver's
education classes, worksite driver education, media development & implementation.
Dakota
Douglas
Draft June 22, 2006
10
CHB/County/City
Freeborn
Goodhue
Hennepin
Houston
Hubbard
Isanti
Itasca
Draft June 22, 2006
Group that was considered successful
PH is a partner in the Freeborn County ZAP (Zero Adult Providers) initiative. The
program focused on preventing alcohol use and abuse by teems. This was
accomplished through a focused effort of local law enforcement agencies, city and
county attorneys, judges, all school districts, the medical center, chemical dependency
treatment centers, PH and Human Services. The goals were to increase the number of
underage drinking arrests and the number of adult provider arrests. The consequences
for underage drinking and for the adult provider were strengthened and applied
consistently. The number of underage drinking arrests increased dramatically. There
were no juvenile fatalities in the County in 2005 as compared to 3 in 2004. The number
of adult providers who were arrested jumped 500% in 2005 as compared to 2004. The
program was initially grant funded but will now be continued with funds contributed from
both private and public partners. The program outcomes have been presented
regionally and at state and national meetings.
The public health department convened two working groups based on the 2005
community needs assessment to address the issues of healthy lifestyle choices and
pharmaceutical drug costs and insurance issues. The first working group is called the
Healthy Lifestyle Choices working group. This group includes residents from around the
county and is working on the HCHB outcomes 4 and 5. This group initiated the "Do"
campaign in Kenyon in the summer of 2005, sponsored a community fitness event in
the fall of 2005, developed a virtual walking tour of the county through community
education, sponsored a theater production for elementary students on the new food
pyramid, conducted a nutrition/fitness class for seniors at the Zumbrota Towers
(assisted living facility/senior housing) and collaborated with the Make the Move Red
Wing group with their on-line walking program through America on the move. Public
health convenes the meeting, types of minutes of the meetings, develops promotional
material and technical assists this group in meeting its goals. The second working
group works on health insurance and prescription drug issues. This group includes
residents from around the county as well as professionals working with county residents
in the areas of social advocacy. This group started meeting in June of 2005 and meets
about once per month. Activities of this group have included developing information
from local pharmacies about discount programs available for residents as well as
information about the commonly asked questions about pharmaceutical medications.
Community meetings were held in the county that addressed the issues of insurance,
pharmaceutical drug coverage and the new Medicare D issues in the fall of 2005. In
these community meetings, a panel was available for questions that included the local
pharmacist, a local health care provider, a community advocate, and an insurance
expert to discuss the issues of pharmaceutical drugs and health insurance. Other
meetings also included a Medicare D expert from the local Area Agency on Aging as
well as a county social worker to discuss issues important to residents on governmental
programs. Goodhue County Public Health serves as the convener of the prescription
drug/health insurance group that provides technical assistance to this group in the way
of organizing meetings, typing up minutes of the group, sending out press releases or
other assistance as needed.
Cater to Health Minneapolis-St. Paul They promote healthy nutrition practices in TC
metro rea workplaces. Hennepin is the convening partner
Meade Screening Group-IEIC addressed the healthy growth and development of
infants. Infants 4-6 months screened at ECFE sites and through home visits. The role of
LPH was to plan the screening events, identify infants, invite to screening, perform the
screening, provide and coordinate follow-up, as well as ongoing collaboration with
partners. The interventions addressed were connecting infants/families to resources,
identify infant delays, teach normal growth and development. Results included the early
identification of infants with special needs, enrollment in FAP, as well as others.
We have developed Healthy Park Rapids 2010 to work on physical activity, good
nutrition, and smoking prevention at a county level.
Health Fair sponsored by the Wellness Committee brought in 15 health related vendors
including screening for hypertension and diabetes
Children First Invest Early
11
CHB/County/City
Kanabec
Kandiyohi
Koochiching
Lake
LeSueur
Lincoln Lyon Murray
Pipestone
Mahnomen
McLeod
Meeker
Draft June 22, 2006
Group that was considered successful
The Health Department convenes the Kanabec County Meth Action Group which is a
coalition focused on the meth issue in Kanabec County. The coalition has developed
strategies under the areas of prevention and education; treatment and intervention; and
legislation and enforcement. The goal is to decrease the illegal use of meth. The group
has been seeking grants to support the strategies identified and is looking to all sectors
of the community to contribute in the effort.
Kandiyohi County Tobacco Coalition continues to focus on youth tobacco prevention
through SWAT teams. Local resources from foundations as well as $20,000 of county
resources support our youth prevention work in 2 public and 2 private schools. Public
Health has 2 board positions, including chair, as well as one county commissioner on
the board.
Partnered with Koochiching Family Collaborative to provide needed parenting "Love
and Limits" classes on regular basis. Partnered with Family Collaborative to help initiate
"Parents Forever" (classes and counseling for families going through divorce). This
class can either be by voluntary enrollment or court ordered. Partnered with community
agencies and initiated and sought funding for "Koochiching Family Planning" center.
Collaborated with the Falls Memorial Hospital to provide "Childbirth, Labor and
Delivery" classes for expectant couples. Is an active member of the Koochiching County
Child Protection Team. Implemented and maintained a Peer Mentoring Breastfeeding
Program. Koochiching County Health Department also provides the following activities
and services: WIC, Follow Along, ENABL, CTC, ECS, Universal Home visiting, MCH,
TANF MCH, Assessment, case management and care coordination, information and
referral for parents and children with special needs
Nursing Network for Bioterrorism, Disease Prevention and Education
The LeSueur county "Family Services Collaborative" is a successful group that partners
Public Health, Human Services, Schools and court services. The HCHB outcomes
worked on are: decrease the percentage of youth in 9th grade who use alcohol or
marijuana. The invention worked on was hiring a chemical dependency counselor to
work with school age children. The group meets regularly and actively prioritize and
evaluate the direction of the group, make decisions re: how monies are to be spent and
support the activities of the staff.
1. Prairie Regional Health Alliance * focused on reduction of childhood injuries poisoning * collaborated with Minnesota Poison Control * member of the Alliance along
with other Public Health offices in SW Minnesota; Health Plans- Blue Cross/Blue Shield,
UCare, PrimeWest; and Affiliated Community Medical Center Health System *
interventions - outreach, health teaching, collaboration, coalition building, community
organizing, social marketing * results - final report not available 2. Early Childhood
Initiative * promote optimum growth and development of young children to assure
readiness for school * collaboration with community partners - ECFE, HeadStart,
Extension, United Way and Ministerium * interventions - outreach, collaboration,
community organizing
Teen Pregnancy Prevention, Suicide Prevention
Healthy Communities-worked on increasing physical activity
Healthy Communities Team (addressed HCHB outcome of Promoting Physical Activity)
developed a physical activity display and education campaign for the county fair booth;
Local Area Rural Partners in Prevention (LARPP) is a community coalition organized
and lead by public health that works to address ATOD issues among youth (addresses
HCHB outcomes of Preventing Alcohol Use and Abuse, Methamphetamine Use, and
Other Drug Use, and Preventing and Reducing Tobacco Use) by working with schools
and community groups that serve teens to provide education and healthy alternative
activities for youth and their parents; Litchfield Early Childhood Initiative (addresses
HCHB outcome of Child Growth and development) is a grass roots community coalition
in which public health is a stake holder which initiated the community assessment
process to identify gaps and trends impacting young families; The Project Harmony
Coalition (addresses HCHB outcome of Preventing Alcohol Use and Abuse, Other Drug
Use, and Methamphetamine Use) is a community coalition organized by public health to
focus on chemical health issues among pregnant and parenting women; The Obesity
Initiative (addresses HCHB outcomes of Nutrition and Promoting Physical Activity)
organized in 2005 under the auspices of a local physician and a health educator from
public health to initiate an obesity prevention campaign to promote physical activity and
12
CHB/County/City
Group that was considered successful
healthy nutrition; public health is a member of the PACT 4 Families Collaborative
(addresses HCHB outcomes of Mental Health, Methamphetamine Use, Suicide
Prevention, Violence Prevention, and Child Growth and Development) which
contributes funding to universal contacts for pregnant women and families of newborns
and the home visiting program which focuses on parenting education.
Mille Lacs
Morrison
meth group - MLC- MEADA
Youth Group, CPT, MCICC, Alcohol & Tobacco, IEIC
Mower
Nicollet
Norman
Olmsted
Otter Tail
Polk
Pope
Redwood Renville
Rice
Draft June 22, 2006
Mower County public health partnered with Family Connections the local family services
collaborative to provide an enhanced school health nursing service to all schools in
Mower County.
COMBAT - established website for promoting nutrition to combat obesity - 191,489
visitors - 13.6% 2-15 minutes in duration; 8.9% 15 min to more than 1 hour in duration
Norman County Child Protection Team-Drug & Alcohol Speakers in the Schools IEIC
Child Find-Identified developmental delays
The Steps to a Healthier Rochester Community Consortium is a community-based
coalition aimed at improving nutrition, increasing physical activity and educating on
asthma, tobacco use and its exposure through agency partnerships. Through the Steps
Consortium, a collaboration has developed between Olmsted County Public Health
Services, the Rochester Area Family Y, and the Olmsted County WIC Program to
create the Fit WIC physical activity initiative. This program is aimed at preschool
children and parents of the WIC program in efforts to increase levels of physical activity.
Incorporating family based physical activities balanced with healthy eating habits helps
to set behaviors resulting in healthy weight maintenance/improvement for preschool
participants and their parents. Fit WIC physical activity kits are equipped with tools to
increase play and activity for preschoolers. The kits are distributed to 3 & 4 year olds in
Olmsted County. Over 200 families have been reached through the Fit WIC physical
activity kits during the first 6 months of implementation and pre/post tests are currently
being examined. Results are yet to be determined until the end of the first program
strategy year (September 2006). To compliment this program, the Rochester Area
Family Y received grant funding to offer a fitness component for parents enrolled with
WIC. Parents or caregivers enrolled in WIC are able to experience the variety of fitness
programs available at the Y through the "Fit WIC the Y's Way" four week program.
Meanwhile, their children are able to have structured physical activity time while parents
engage in the Y fitness program. Pre/post surveys will be evaluated after conclusion of
activities in June 2006.
Methamphetamine Task Force - Our agency is represented by a Public Health Nurse.
This group has developed policies for child protection issues, medical protocols, and
community action planning to address meth issues
Immunization Coalition. Month of the Child activities. Dental Coalition, NE North Dakota
and NW Minnesota, planning for a new dental clinic. Parents Helping Parents. Child
Protection Teams.
Boarders united for Smoke Free Air. Eight county project. Pope Co. PH role was to
implement project activities in Pope Co. 2005 focus in Pope co. was providing SHS
education to community groups, businesses, daycares, WIC etc. Activities include
working with junior and senior high youth providing peer education to younger students
regarding non tobacco use. HCHB outcomes worked on are outcome 8 and 9 decreasing percentage of youth and adults who smoke
PACT 4 Meth advisory group the established toll free hotline, speakers bureau, did
billboards & PSA's
Rice County Public Health is an active participant in the Health Quest program in
Faribault. Health Quest was convened by District One Hospital and is a coalition of
organizations that is promoting health lifestyles by emphasizing nutrition and exercise.
One outcome of Health Quest efforts has been the opening of an indoor track for public
walking during the morning hours. This was a direct outgrowth of Health Quest and has
been attracting a significant number of walkers.
13
CHB/County/City
Richfield
Roseau
Scott
Draft June 22, 2006
Group that was considered successful
In 2005 Public Health convened two school health groups one in the Edina School
District and the other in Richfield School District. Each of the groups sent a team to a
Physical Activity and Nutrition forum (PAN) developed by a collaborative of metro public
health agencies (Hennepin, Dakota, Ramsey, Minneapolis and Bloomington). The
Richfield group invited Public Health to work on the school wellness policies that they
were mandated to complete by July 2006. Edina School worked with Public Health on
a consulting basis because they were farther along in developing the wellness policy.
Each of the groups developed strong wellness policies, presented them to school board
and they were adopted by the district.
Roseau County Wellness Coalition - assess wellness needs for all ages, obesity
problems, nutrition & exercise. Public Health convened and leads group. Community
wide presentations on exercise - "MOVE TO IMPROVE" active living walking program.
Over 200 adults attended. Fourth graders across Roseau County are wearing
pedometers and recording steps & miles each school day. Promote Healthy
Communities Behaviors.
Safe Communities Coalition: HCHB Outcome: Decrease the rate of persons killed and
injured in motor vehicle crashes. Decrease the percentage of youth in 9th grade who
use alcohol. Public Health has or organized and collaborated with community agencies
and groups to promote awareness and education about the consequences of drinking
and driving, providing alcohol to minors, and not using safety restraints/child safety
seats. Public Health has been the fiscal agent for the Safe Communities Grant and is
the lead agency with the initiatives. Examples of interventions and activities include the
following: Promoting chemical Health week in November and Alcohol Requires
Responsibility through press releases in all the local newspapers on a monthly basis.
Collaborating many activities with school, law enforcement, public health such as
sending letters to parents of students turning 16 yrs old that are signed by the County
Sheriff, about the facts about teen drivers and what parents can do to keep their
children safe, also included Parent/Student Driving Contract, in two school districts.
Stickee Shock Campaign, Safe Driving Campaign in May-with portable signs
encouraging seat belt use on heavily traveled roads, increased enforcement after
campaign. "Lights on for Prom"- promoting community awareness and support for
students to have good time and to not drink and drive. Coalition partners promote
awareness at schools and in about the consequences of drinking and driving with a
crash car display. Hospitals and public health collaborate to provide infant car seat
safety checks/education and provide car seats to families that have no resources to buy
one for baby. Established a fatality review committee consisting of different disciplines
to review fatality crashes and identify trends and recommendations of prevention and
intervention. River Valley Nursing Center: Public Health identified gaps for accessing
low cost/sliding fee health and dental care for the uninsured and underinsured in our
communities. Scott County Public Health led efforts to develop a nursing center through
collaboration with PNMC Foundation, SFRMC, Carver County Public Health, Allina
Clinic, CAP agency, and St. Mary's Clinics to provide nursing assessments,
interventions and referrals to meet their healthcare needs. Public Health has partnered
with other members of IEIC to provide education to health providers and parents about
useful development screen tools and to promote early identifications and intervention
with children identified as having delays. HCHB Outcome: Increase the percentage of
children ages 0-3 who are screened for developmental and social emotional issues
every 4-6 months. Public Health also provides information to all new parents in Scott
County about the "Follow Along Program" and encourages them to participate free of
charge. Public Health scores the screening tools and contacts the parents regarding
any identified delays and makes appropriate referrals for follow up. Chemical
Health/Mental Health Task Force: Public Health has organized and collaborated with
community agency members to develop strategies and goals that address the
increasing need of mental health and chemical health services that have decreasing
resources available this year. HCHB Outcome: Decrease the rate of suicides. Decrease
the rate of hospital treated self- inflicted injuries. Decrease the percentage of adults
ages 18 and older who binge drink. Decrease the percentage of youth in 9th grade who
use alcohol or use marijuana. This task force is in the planning stage. A wallet size
chemical health/mental health resources card is being developed at this time.
14
CHB/County/City
Sibley
St. Louis
St. Paul-Ramsey
Stearns
Steele Dodge
Stevens Grant
Traverse
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
Group that was considered successful
Senior Service Partnership meeting is a new collaboration of healthcare providers
started in late 2005. This collaboration addresses the HCHB outcome of Healthy Aging.
Public Health facilitates the quarterly meetings and discussions are held between are
partners. The goal of this collaboration is too share information, and combine resources
to offer the most comprehensive care for senior citizens. An example of this is
discharge planning and having a smooth transition for seniors. There are no
measurable outcome at this point, but networking between providers has been very
successful.
Based on an assessment of her maternal-child home visiting population, a public health
nurse identified a need for a postpartum depression support group on the Iron Range.
In collaboration with key community stakeholders she researched multiple aspects of
perinatal depression including screening protocols, resources, availability of mental
health providers, and the existence of other support groups and their formation. Using
the format of Depression after Delivery, Inc., she convened the "Women Helping
Women", a peer support group for pregnant and postpartum women dealing with
depression.
Steps to a Healthier St. Paul Community consortium working on healthy eating.
Increasing physical activity and reduction of exposure to tobacco. These work to
reduce/prevent diabetes, obesity and asthma. American Lung Association Controlling
Asthma in American Cities Project, CDC funded project research to look at
environmental interventions & to control asthma & project research to look at
environmental interventions & to control asthma & reduce medical interventions. The
Hmong Health Care Professionals Coalition: Planned and sponsored an area
conference to enhance cultural competence and foster dialogue among providers
working with the Hmong community. Almost 300 providers attended and evaluations
were positive.
Stearns County Human Services/Public Health Division played a large role in the
creation of the Stearns County Human Services Youth Task Force that held its first
meeting in 2005. Twenty youth sit on the Task Force representing ten school districts.
The purpose of the Task Force is to give youth an opportunity to provide input and
recommendations concerning programming and policies to the Stearns County Human
Services Advisory Committee. A Juvenile Probation Agent (from Community
Corrections) and a Public Health Coordinator (from Public Health) act as advisors to the
Task Force. Two youth co-chair the meetings. The Task Force will meet six times a
year and discuss issues regarding underage alcohol consumption and driving, bullying,
methamphetamine and other illicit drug use, sexually transmitted diseases, teen
pregnancy, and mental health.
Dodge Co. is involved with a Family Services Collaborative that supports many different
programs/projects such as Big Brothers/Big Sisters. Steele Co. is involved in a
Children's Mental Health Collaborative that help develop prevention programs/projects
such as "First Step" and using ASQ-SE in preschool screening throughout the county.
Both Counties are not developing home visiting programs using the Hawaii modelfunded through grants that are made possible by being a part of a County Based
purchasing group. Being part of CBP has offered our community many service that do
not seem to be available to other parts of the state.
BORDERS UNITED - TOBACCO/HEALTHY GROWTH AND DEVELOPMENT
Todd
1. State Communities coalition 2. Drunk driving-preacher, parent meetings. 3. TANF
Workshop on Meth with Family Service Agencies. 4. Seat belt checks with schools 5.
Billboards and posters in local bars regarding drinking.
Coalition with Head Start for Collaborative FAP Activities, regarding questionnaire for
Spanish.
Wadena
Worked with Todd Wadena Healthy Connections MCH Workgroup to enhance
community and medical provider awareness of key MCH issues including SBS, SIDS,
car seat safety, prenatal health, postpartum depression and domestic violence. Public
Health provided assessment data and education components.
Draft June 22, 2006
15
CHB/County/City
Winona
Group that was considered successful
Substance abuse prevention committee, multi organizational committee which is
currently in the process of writing a grant request for 5 years of funding for prevention of
illegal chemical usage. Public Health instrumental in ongoing functioning of group as
well as grant writing. This group has done a great deal of media campaign around
providing alcohol to minors especially during homecoming, prom, etc. Has worked
extensively with the issue of driving under the influence and is a current participant in a
grant from the dept of public safety for a buckle up campaign in May.
The Wellness Center at the Stillwater Area High School was built on a community
partnership and shared responsibilities with the Stillwater Public Schools, Washington
County Public Health and Environment and FamilyMeans. The Wellness Center allows
students to receive help for chemical dependency, mental health and nutrition issues.
Lakeview Hospital was awarded the Community Health Commitment award for small
hospitals by the Minnesota Hospital Association. The award was given in recognition of
Lakeviews role in opening the Wellness Center.
Interagency Referral Team, IEIC
The public health department has worked to establish an Alcohol, Tobacco and other
Drug Coalition in the county. The purpose of the coalition is to reduce chemical use by
youth and over time reduce chemical use by adults. The agency received a federal
Drug Free Communities grant beginning in October 2005. The coalition is comprised of
county commissioners, a city council representative, faith community, extension, social
services, county attorney, mental health, United Way, Concierge Program, schools and
parents. Some of the activities included: implementing Project Northland in all of the
county school districts and one private school, training the community regarding the
Super Charge component, providing realtor and business training concerning issues
associated with methamphetamine production, providing chemical health prevention
resources to the local faith communities, providing youth leadership training from MDH
(Activation Camp) and the training from the Illusion Theater. The public health agency
provides leadership to the coalition and provides facilitation.
The Winona County MCH Taskforce, which meets twice a year, develops a work plan.
In 2005, a subcommittee named the Breastfeeding Committee met to improve lactation
and breastfeeding by new mothers. Three work groups focused on improving prenatal
information, immediate postnatal support to mothers and provider and staff training.
This resulted in many community outreach and educational effort for the mothers and
providers.
Wright
Families Together - collaborative effort with Early Childhood Family Education (ECFE)
to improve parenting outcomes; in a group setting of existing client families. Activities
include parenting, parent/child interaction, relationships. Outcomes: improved
parenting, reduction in individual home visits. The Wright County Child Health
Committee is in the process of developing a Web-based resource list for Children's
Mental Health; has offered child mental health training to community agencies, and
evaluated and recommended screening tools for children's mental health.
Wasbasha
Washington
Watonwan
Wilkin
25) Are there any activities that the public health department did not perform in the above measures that are being
performed by other organizations?
•
•
•
34 entities responded yes (44%)
39 entities responded no (51 %)
4 entities responded unknown (5%)
Draft June 22, 2006
16
If yes, explain:
CHB/County/City
Blue Earth
Activities performed by other organizations
Alternative Care / Elderly waiver / Senior clinics / foot clinics thru Health and Human
Services. Public health nurses are include in the social service budget not public
health
St. Mary Clinic - community clinic for underinsured persons.
STD and Pregnancy Prevention activities are being provided by Planned Parenthood
in our community. Yellow Ribbon and the Mental Health Initiative work on Suicide
Prevention. HIV education provided by schools, RAAN, MnSU, M Student Health
Center. MnSU, M also active in alcohol, drug and tobacco education with the young
adult population.
Carlton
Social marketing done through Safe Schools/Healthy Students Grant
Aitkin
Anoka
Koochiching
Lake of the
Woods
Violence Prevention is being addressed by two local community groups in the county.
Family Safety Network addresses domestic violence and receives referrals.
Partnership with numerous agencies in the county helped to develop a mentor
program.
Jackson Trail System -- Physical Activity Smoking Cessation -- Reduce the Use of
Tobacco Phy Ed in every school in two counties -- Physical Activity Private Physician
Clinics -- Sexually Transmitted Infections/ Disease Prevention Jackson County
Extension Nutrition Educator -- Nutrition Jackson Medical Center -- Healthy Aging
topics of education
ENABL, School’s Clinics/Hospitals, Law Enforcement, County Attorney & Social
Services
We collaborate with many organizations that may perform some of the activities listed
above but at different intensities than we do.
Suicide prevention and comprehensive HIV support/education.
City of Fairmont has a healthy communities committee that developed community
norms. Wells also has a healthy communities that works on a variety of issues related
to children and youth.
The Albert Lea Medical Center sponsors several education programs throughout the
year on such topics as women's health, diabetes, healthy eating. Albert Lea
Community Education sponsors a variety of exercise classes. Planned Parenthood is
a resource for identifying and treating STI/STDs as well as addressing other
reproductive health needs. This is probably an incomplete list.
Chemical health issues are being addressed by the Goodhue County Chemical Health
Coalition that has funding from the federal government as well as the local family
services collaborative. Public health is part of this collaborative group. Suicide
prevention services are provided at least in Red Wing by the Yellow Ribbon coalition
which includes Fairview Red Wing Health Center as the convener of this group.
Family Planning methods are provided by Outlook Clinic, which is housed in PH office
1 day a week
Kootasca Community Action provides early headstart and home visiting for their
families enrolled in their programs. Kootasca is also using the Follow Along for ASQ's
for Children over 36 months. By the 06-07 school year, all school districts in
Koochiching County will be offering 3 year old pre-school programs.
Are numerous activities provided by other organizations, some in coordination and
collaboration with public health.
LeSueur
Lincoln Lyon
Murray Pipestone
CD counselor is hired by the Family Services Collaborative. Worksites and Schools
promote increasing physical activity. Yellow Ribbon group works on suicide prevention
education and outreach. RAAN (Rural Aids Action Network) provides medical care,
testing and counseling. Mental Health case management is provided by DHS.
Enforcement of laws related to violence, meth ordinance, etc. provided by sheriff and
police departments. Sage program does cancer screening. Open Door Clinic in
Mankato provides STD testing, medical care and counseling.
Suicide and Tobacco Prevention - Yellow Ribbon Campaign - organized and
conducted through the area schools
Cass
Cook
Cottonwood
Jackson
Crow Wing
Dakota
Douglas
Faribault Martin
Freeborn
Goodhue
Isanti
Draft June 22, 2006
17
CHB/County/City
Marshall
Morrison
Mower
Nicollet
Otter Tail
Pennington
Red Lake
Redwood
Renville
Rice
Roseau
Activities performed by other organizations
Violence Intervention Project provides services/advocacy for victims of physical and
sexual abuse.
Social Services for Child Protection
The Mower County Early Childhood Initiative funded by the Southern Minnesota
Initiative fund is working on early health and learning needs of young children in
Mower County. Mower County public health serves on the planning committee.
If this applies to all sections in this category - certainly - medical providers, social
service agencies, mental health agencies, etc.
STI testing is provided by RAAN, Otter Tail Wadena Community Action Council, and
also private providers
WIC is provided through QUIN; Citizens for Smoke Free Air promote prevention of
tobacco use
WIC is provided through QUIN, Health Promotion Coalition
New Horizons Crisis Center-abuse, unintended pregnancy; Choices Pregnancyunintended pregnancy; Extension-various health & environmental educational
services; Area hospitals & clinics-diabetes classes, prenatal classes, other support
groups & classes; Faith Community-support services, parish nursing.
There is a collaboration sponsored by the Rice County Family Services Collaborative
that is addressing the treatment and prevention of alcohol and other drug use by Rice
County youth. Rice County Public Health has been involved with the group but has not
been a major partner. (Rice County Public Health is, of course, an active member of
the Family Services Collaborative.)
Family planning
St. Louis
Preventing Unintended Pregnancies, the local family planning program Rum River
Health Services provides a comprehensive program including methods
All medical providers screen child growth and development. All school districts and
Human Service agencies partner with public health in the area of IEIC and IRT.
St. Paul-Ramsey
Ramsey County is a community of over 500,000 residents with many health
organizations and community groups which collaborate and partner to improve the
health of the community.
Stearns
Suicide prevention has been identified as a priority, but it was not addressed in 2005.
Community organizations that do address this topic include the local medical and
mental health providers. Being a part of Stearns County Human Services, the Public
Health Division does not take the lead role in mental illness matters. Stearns County
Human Services/Children's Mental Health and Adult Mental Health take the lead and
Public Health participates.
Wasbasha
Violence prevention, our sheriff's dept and local law enforcement departments have
grants they utilize to provide education on this issue.
Waseca
Preventing Alcohol Use and Abuse - Waseca Medical Center, Family Focus
Sherburne
Draft June 22, 2006
18
Summary Analysis of
Prevent the Spread of Infectious Disease
1) The public health department monitored and analyzed infectious disease risk, occurrence, and reporting to
identify disease trends and reporting gaps.
•
•
71 entities responded yes (92%)
6 entities responded no (8%)
CHB/County/City Explanation
Anoka
Yes, to a limited degree.
Benton
We do not have the capabilities to do this.
We receive and review data, but are currently in the process of creating systems
Carver
and training staff to further analyze the data.
We don t receive data from MDH in a timely fashion or manner that allows for
analysis. Other diseases, such as pertussis and TB, we keep track of our data,
Dakota
routinely monitor and analyze our caseload and report trends to PH administration.
Isanti
do not have the capacity
Minneapolis
Contract with Hennepin County
Mower
Pertussis, West Nile Virus
Lack of data. Did receive information from MDH regarding pertussis but MDH
Pope
did investigation due to new staff issue.
Redwood Renville District EPI handles & informs local PH
2) The public health department monitored and analyzed immunization data and practices to identify
immunization trends and practice gaps.
•
•
69 entities responded yes (90%)
8 entities responded no (10%)
CHB/County/City Explanation
Benton
We do not have the capabilities to do this.
We receive and review data, but are currently in the process of creating systems
Carver
and training staff to further analyze the data.
Freeborn
No IPI visits done in 2005; no requests to analyze Immunization data
Minneapolis
Provided by Hennepin County
Mower
Annual report on % of two year olds adequately vaccinated in Mower County
Nobles Rock
In transition due to loss of Agency Administrator.
Pope
Immunization registry
Sherburne
data not available
St. Paul-Ramsey
No longer have Retrospective Data; MIC not ready to be analyzed
3) The public health department provided infectious disease and immunization information and education to
local providers on the following topics or by providing the following tools: [check all that apply]
Information/Education to local providers
DP&C Common Activities Framework
Draft June 22, 2006
Number of Entities
25 (32%)
1
Information/Education to local providers
MN Reporting rules
Report cards
MDH 24/7 disease reporting and foodborne illness
hotline numbers
Disease risks, occurrences and trends
Current MDH or CDC recommended guidelines/best
practices for STD/HIV prevention testing and treatment
Current MDH or CDC recommended guidelines/best
practices for TB prevention, screening, diagnosis and
treatment
Refugee Health Assessment protocols
Standards for Pediatric and Adult Immunization
Practice
Use of immunization registries
Immunization trend information/data
Standards for proper vaccine storage and handling
Other.
Number of Entities
56 (73%)
49 (64%)
56 (73%)
51 (66%)
17 (22%)
49 (64%)
30 (39%)
65 (84%)
71 (92%)
51 (66%)
67 (87%)
See Below
Other infectious disease and immunization information and education to local providers
STD service through contract with Nucleus Clinic
"Antimicrobial Susceptibilities of Selected Pathogens"
Perinatal hepatitis B trends, risks and recommended CDC guidelines for immunization
Immunization Update Satellite Conferences, Flu Vaccine Supply Coordination (MIVOL)
Pertusis
The Immunization practices and Improvement is completed by MDH for Kanabec local
providers.
pertussis info, polop, influenza distribution, HAN alerts re: infectious diseases, ITV-MIIC
Provided by Hennepin County
Influenza, Katrina medical recommendations
Providing current vaccine information sheets (VIS)
EPA Guidance of sharps handling for the general public, MDH Treatment and Prophylaxis
guidelines on Pertussis, MDH & CDC Surveillance and testing of Avian Influenza
Flu Plan 2005
Handwashing
-Pertussis Education; Each clinic is shown the reference book "Infectious Disease in Childcare
Settings and School" and given ordering information.
4) The public health department provided the following total number of doses for/of:
Pediatric Doses:
Number of
entities that
responded
Number of
entities with no
data
Average number
of doses
Draft June 22, 2006
DtaP
Hib
MMR
Polio
Varicella Hep B
PCV7
Flu
69
67
69
69
68
69
68
68
8
10
8
8
9
8
9
9
80
35
139
106
72
179
42
73
2
Pediatric Doses:
Std. Deviation
Minimum
Maximum
Total number of
doses
DtaP
Hib
MMR Polio
Varicella Hep B PCV7 Flu
75
41
225
173
158
180
51
203
0
0
6
0
0
4
0
0
329
260
1346
1003
1067
1103
324
1594
5537
2330
Adult Doses:
Number of entities that
responded
Number of entities with
no data
Average number of doses
Std. Deviation
Minimum
Maximum
Total number of doses
CHB/County/City
Anoka
Beltrami
Benton
Bloomington
Brown
Carver
Chisago
Clay
Clearwater
Cottonwood
Jackson
Crow Wing
Dakota
Edina
Faribault Martin
Fillmore
Freeborn
Goodhue
Kandiyohi
Kittson
Koochiching
LeSueur
Lincoln Lyon
Murray Pipestone
Marshall
McLeod
Draft June 22, 2006
9623
Td
7281
Flu
4865
12354
2824
4983
Pneumoccal Hep B
66
67
62
66
11
128
225
0
1651
10
947
985
0
5524
15
11
22
0
110
11
101
122
0
602
8425
63419
676
6698
Other Doses
vaicella 49 mmr 66 hep a 1
hepatitis A 27
Comvax 1
Hep A: 53, MMR: 64, Varicella: 44
Tdap 2
Hepatitis A, 1 pediatric & 13 Adult; Meningococcal
(MCV4), 4 pediatric
MMR-5;Polio-1;Varicella-1
MENACTRA - 2
IPV 9
Polio 3
Varicella 4, MMR 7
Prevnar- 47; Varicella - 43; Polio - 5; Hepatitis A 26
kids and 57 adults; Meningococcal 21 kids and 1 adult;
253 Td children
MMR: 3, Varicella: 3
MMR=1 Polio=1
IPV - 100
IPV- 1 dose
Hepatitis A - 10
MMR-90 Varicella-66
Typhoid-3; Hepatitis A-15
15, menomum menactra
1-MMR; 1-Varicella
MMR - 33 doses and Varicella - 25 doses
Hep A - 2
MMR-2, Hep A-17, Varicella-1
3
CHB/County/City Other Doses
Mower
GCG-TB 57
Olmsted
Otter Tail
Redwood Renville
Rice
Richfield
Sibley
St. Louis
MMR - 285; Hepatitis A - 28; Varicella - 224
20 - Hep A
MMR-3; Varicella-4
MMR 77; varicella 75; gave over 1600 doses of Flu
vaccine
MMR: 16, Varicella: 4
Varicella-4, MMR-2, Polio-1
MMR-19
St. Paul-Ramsey
Stearns
Steele Dodge
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
HepA 422; IG 40; Japanese Encephalitis 7; Meningitis 9
MMR 73, Polio 2, Varicella 70
Varcella 50, MMR 71, Polio 28
Todd
Waseca
Washington
Watonwan
Wright
Adult Td includes ages 7 years to 100 years
td-preservative free 18 doses
10
Hep A - 2 doses, Meningitis - 3 doses
MMR 3; Polio Inject 2
Pediatric menactra-3, Pediatric menomune 12, TD-240
5) The public health department provided infectious disease and immunization information, education and tools
to the public on the following topics: [check all that apply]
Information/education to the public
MDH foodborne illness hotline number
West Nile virus
Lyme disease
HIV
Chlamydia and other sexually transmitted infections
Recommended childhood and adult immunization
schedules
Immunization risk benefit information
Use of immunization registries
Immunization trend information/data
Other.
Number of Entities
47 (61%)
68 (88%)
58 (75%)
47 (61%)
47 (61%)
76 (99%)
63 (82%)
68 (88%)
38 (49%)
See below
Other infectious disease and immunization information and education to the public
waterborne illness, hepatitis A, influenza, rabies, TB, hepatitis b, hepatitis c, meningitis,
pertusis
Influenza
Influenza-like Illness & Influenza
Pertussis, Hep B and other VPD's
Avian flu; Family emergency preparedness for infectious diseases
Blood born pathogens, Infectious Diseases, Infection Control, Pertussis, TB/LTBI,
Draft June 22, 2006
4
Other infectious disease and immunization information and education to the public
handwashing
LaCrosse Encephalitis
Flu
Pertusis, influenza, day care workers
Influenza
Influenza
Pertusis, Chicken Pox, Polio, Influenza
Influenza, pandemic flu, bird flu, polio, TB
Pertussis
Parapertussis, pertussis, LTBI, Travel Vaccinations, Pinworm, Immigration Immunizations,
BBP issues, Head Lice, TB exposure, Strept Throat, Hepatitis C, Animal Bites, Rabies,
Giaddia
Flu Plan 2005, Breaking News on Website
Head Lice, Avian Influenza, Pandemic Influenza
Handwashing; prenatal Hep B transmission and prevention
Avian Influenza, Influenza
Pertussis and Chronic wasting disease
Head Lice Treatment and Prevention
Tree Hole Mosquito, pertusis and prevention of it's spread, influenza and vaccination, e-coli
education due to outbreak
Avian Influenza, TB, Hep B
6) The public health department updated disease reporting facilities’ contact information within jurisdiction
(reporting facilities include clinics and hospitals that must report infectious diseases by law).
•
•
60 entities responded yes (78%)
17 entities responded no (22%)
7) The public health department did the following disease investigations:
Level of disease investigation
Assisted in and/or
Conducted case investigations into vaccine preventable
diseases.
Assisted in and/or
Conducted case investigations into other outbreaks
(besides foodborne or waterborne disease outbreaks*).
Specify type of outbreak.
Other Outbreaks
pertussis
TB
lice
norovirus
meningitis
Draft June 22, 2006
Number of entities that responded
37 (48%)
24 (31%)
11 (14%)
See below
Entities that
responded
15
5
3
3
2
5
Entities that
responded
Other Outbreaks
polio
2
chicken pox
1
chlamydia
1
Hep B
1
measles
1
MRSA
1
norwalk
1
rabies
1
scabies
1
west nile
1
*Reporting for foodborne and waterborne disease outbreaks is in Protect Against Environmental Health
Hazards.
8) The public health department provided or contracted for direct observational therapy (DOT) to those TB
cases that needed it.
•
•
40 entities responded yes (52%)
37 entities responded no (48%)
o 29 entities responded with a reason for not providing DOT
Reason for not providing DOT
No cases/none required
Done by Hennepin County
Number of
entities
Percent
25
32%
4
5%
9) The public health department identified, located, evaluated, and monitored contacts of infectious TB cases
based on MDH/CDC standards.
•
•
36 entities responded yes (47%)
41 entities responded no (53%)
o 33 entities responded with a reason
Reason for not identifying TB
contacts
No cases/none required
Done by Hennepin County
MDH did this
1 Referral - Not in County
Number of
entities
Percent
27
35%
4
5%
1
1%
1
1%
10) Are there activities that the public health department did not perform in the above measures that are being
performed by other organizations?
•
•
30 entities responded yes (39%)
47 entities responded no (61%)
Draft June 22, 2006
6
CHB/County/City
Anoka
Bloomington Edina
Richfield
Blue Earth
Carver
Cottonwood
Jackson
Dakota
Douglas
Faribault Martin
Freeborn
Houston
Lake of the Woods
LeSueur
Meeker
Mille Lacs
Minneapolis
Mower
Nobles Rock
Pine
Redwood Renville
Rice
Scott
Sherburne
Sibley
St. Louis
Stearns
Steele Dodge
Stevens Grant
Traverse
Draft June 22, 2006
Activities performed by other organization(s)
Nucleus Clinic – family planning
Hennepin County does TB investigations and follow-up
MnVFC are being provided to uninsured residents at the Open Door
Health Center
The MDH conducts most of the disease investigations in Carver County.
STD Education
Immunization - 95% of all given in Dakota County are provided in the
private sector. TB follow-up - have contract with St Paul/Ramsey TB
clinic as well as private providers do follow-up. MDH is primary for
doing follow-up on HIV and STI's.
HIV education and STD are both addressed by Planned Parenthood and
Public Health
Public influenza vaccination clinics are available through out the 2
counties via medical clinics, pharmacies, etc.
District Epidemiologist conducts disease investigations in Freeborn
County.
Performed by MDH
MDH conducts disease investigation as indicated; local public health
would assist as requested and able. There were no disease investigations
in Lake of the Woods County in 2005.
Regional epidemiologist takes the lead in disease investigations and we
only assist as requested.
MDH completes case investigations, we have provided assistance as
needed
The 1 case in the County was monitored by the Mille Lacs Band
City contracts with Hennepin county for disease prevention and control
services. Contracts for services with community clinics - includes
immunizations.
District MDH office in Rochester provided disease surveillance and
investigation.
MDH and Regional Epidemiology Consultants.
Contract with the Outlook Clinic for Family Planning services, which
would include information on STD's and HIV.
Done by District EPI
MDH is the lead agency for investigating and following up on
communicable disease outbreaks other than Tuberculosis.
Have contract with an Infectious Disease clinic, which sees our potential
TB clients for evaluation, if they are uninsured and have no local primary
care MD.
MDH did disease investigations for most communicable diseases
Specific MDH case investigations
Some physicians do TB follow-up and/or DOT with their own patients.
HIV and STI education is provided by medical providers, the Red Cross,
and the Pregnancy Resource Center (located in the City of St Cloud)
All extra-pulmonary
STATE
7
Todd
Winona
MDH Pertussis Case Investigations, STD testing available at Public
Health/Clinic Collaborative of the Rural Health Outreach Grant Family
Planning Clinic. Medical Clinics.
MDH Epidemiologist does the contacts and follow-up in SE MN. We do
not have the staff.
Intermediate Results
Answers for questions 1, 2a and 2b are in the below table.
1) Total number of primary and urgent care clinics and hospitals in jurisdiction:
2a) Number of clinics and hospitals contacted (either in-person or via the telephone) by the public health
department to provide information/education on infectious disease reporting:
2b) Number of clinics and hospitals contacted (via other methods, such as newsletters or emails) by the public
health department to provide information/education on infectious disease reporting:
Number of
primary/urgent care Number contacted
clinics and hospitals in person or by
(Q1)
telephone (Q2a)
Number of entities that
responded
Number of entities with no
data
Average
Std. Deviation
Minimum
Maximum
Total
Number
contacted by
other methods
(Q2b)
75
64
67
2
12
22
1
151
912
13
8
14
0
105
539
10
12
23
0
151
816
MDH will eventually provide the data for question 3.
3) Total number of vaccine preventable disease case investigations (probable and confirmed).
4) Did the public health department perform other disease case investigations (excluding foodborne and
waterborne disease case investigations*)?
•
15 entities responded yes (20%)
CHB/County/City
Carlton
Carver
Crow Wing
Douglas
Hennepin
Olmsted
Otter Tail
Pine
Other disease case investigations performed
TB - 1; Pertussis - 1
Scabies, 17 suspected cases & 3 clinic confirmed cases
Assisted with pertussis (2) and EColi (2)
Animal Bite
Measles
One person-to-person Norovirus
Meningitis - 1, Rabies
Chlamydia. One case investigation.
Rice
Scott
Tuberculosis; 60 persons from 52 families were included
Pertussis 30, other 5
Draft June 22, 2006
8
CHB/County/City Other disease case investigations performed
TB, 127 investigations (not including cases identified in the
Stearns
jail)
Steele Dodge
Pertussis 15-20
Washington
TB, 8 cases
Winona
polio, TB
*Reporting for foodborne and waterborne diseases is in Protect Against Environmental Health Hazards.
5) The public health department identified local infectious disease trends or gaps.
•
•
42 entities responded yes (54%)
35 entities responded no (46%)
CHB/County/City Local infectious disease trends or gaps
Anoka
Yes on a very limited basis.
Bloomington
Edina Richfield
An increase in reported pertussis cases
Pertussis outbreak - health care providers where not isolating those infected
for 5 days. -schools were having difficulty enforcing isolation for infected
Blue Earth
children.
Cass County saw a rise in the number of reported Lyme infections. Staff
from MDH assisted with education and outreach materials. Local public
health staff compiled materials for the medical clinics and submitted public
education to the area newspapers. Reports were given to the Public Health
Cass
Advisory Committee.
Several cases of pertussis in local school districts-worked with school nurse
Chisago
and other staff to assure dissemination of accurate information
pertussis cases increased in Amish community polio risk increased in Amish
Clearwater
community
Cook
School - influenza
Cottonwood
Jackson
Increase in the number of STD
Analyzed STD rates, service delivery, gaps in availability of low cost testing
services within the county and in educational outreach; Evaluated rising
Dakota
pertussis trends in early 05.
Followed pertussis outbreak as provided by MDH epidemiologist. Assisted
Faribault Martin
in providing information to community.
Fillmore
contacted all Amish residents and attempted to get a disease history
Increase in pertussis cases, Increase in STD cases, decrease, but monitor the
West Nile Virus, LTBI project- identified possible gap in providers
reporting, treating and referring, identified Norwalk-like outbreaks in
Goodhue
schools, influenza tracking and the MRSA outbreak
Pertussis in schools, school surveillance for non-reportable diseases, STD
Hennepin
HIV analysis
The department did analyze the number of cases reported by MDH for local
Kanabec
jurisdiction.
Chlamydia continues to be the most prevalent, Pertussis on the rise, TB cases
Kandiyohi
vary from 0-3/year
Lake
Community Health Board Planning Process
Draft June 22, 2006
9
CHB/County/City Local infectious disease trends or gaps
Medical providers not testing for pertussis, proper treatment, exclusions,
McLeod
education to patients
The department received fewer requests for information and/or head lice
checks than in past years. 9 persons were checked, 3 cases of head lice were
Meeker
identified.
On a small scale we will monitor a report we receive from the community or
Mille Lacs
MDH
Minneapolis
STDs
Mower
increase in number of confirmed pertussis cases in Mower County
Olmsted
Otter Tail
Pine
Polk
Redwood Renville
Rice
Roseau
Scott
Sibley
St. Paul-Ramsey
Stearns
Steele Dodge
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
Todd
Waseca
Washington
Watonwan
Winona
Draft June 22, 2006
No significant increase in any specific diseases
Increased caseload of TB clients, Pertussis in the Amish Community, and the
increase in the reporting of Chlamydia
Increase in Chlamydia cases in Pine County. High risk of Lyme Disease.
Increase in Pertussis
stable
Increasing need for TB follow-up of persons without insurance to pay for
care.
TB in deer and cattle
Pertussis- Gap in exclusion advice at local Urgent Care
Increase in pertussis cases
2004 Ramsey County Disease Report, August 2005
Trend: (1) TB continues to be a concern regarding the foreign born persons
moving to Stearns County. (2) Stearns County is seeing an increasing
number of LTBI in the jail setting. Gap: There is a service disconnect
between the jail LTBI population and the Health Protection and Promotion
Unit where the TB investigations take place. Strategies are underway to
address this gap.
Inc. Id of pertussis. Inc. of foreign born residents that from areas of the world
where diseases such as TB, HBV and HIV/AIDS are endemic.
1. An increase in pertussis was found in our communities 2. Increase in
Chlamydia -underreporting of STD's 3. Reluctance of Health care providers
to use flu mist.
1. No significant change in reportable disease statistics with exception of
Polio Outbreak in Amish. 2. Possibility of unreported Pertussis exists in
Amish as may not seek healthcare.
pertusis, west nile
Increase in pertussis and mumps cases over past few years.
Received multiple calls from schools, clinics and community members
regarding cases of Pertusis in the community.
In 2004 a trend was noted, due to receiving Gunderson Lutheran Systems
monthly Infectious Reportable Disease reports that many Winona County
residents were positive for Lyme Disease. The MDH SE epidemiologist
was contacted and he made arrangements for specific new releases to occur
in the Spring of 2005 directly to the media on how persons could prevent
Lyme disease. This lead to local stories and hopefully prevention measures
taken by the general public, or an increase in seeking earlier treatment, as
tick control is very difficult.
10
CHB/County/City Local infectious disease trends or gaps
We keep a log of all diseases reported to us locally and then this information
Wright
is reported to MDH.
6) The public health department identified local immunization trends or gaps.
•
•
46 entities responded yes (60%)
31 entities responded no (40%)
CHB/County/City
Aitkin
Blue Earth
Cass
Clearwater
Cook
Cottonwood
Jackson
Dakota
Douglas
Faribault Martin
Fillmore
Goodhue
Hennepin
Isanti
Itasca
Draft June 22, 2006
Local immunization trends or gaps
Retrospective kindergarten study
4th dose of Dtap frequently missed, worked to increase awareness in clinics,
and to notify those missing dose. 4th dose of prevnar missed due to shortage
of vaccine in community
There has been a decrease in the number of families utilizing the Public
Health Immunization Clinics for their children. This may be due to the
increase in those assigned to primary care clinics through PMAP and/or, the
tightening of criteria for the use of the Minnesota Vaccines for Children
vaccine. Annual immunization status reports for school aged children for
2004-2005 remained high; there is a growing group of conscientious
objectors in one school district. A Cass County Public health nurse is a
member of the immunization focus group that enhances our immunization
documentation and tracking program within the PH Documentation system
used by 21 counties. This committee meet regularly with state
Immunization staff to maintain integrity between PH Doc and MIIC. This
has proven to be a successful partnership.
Amish population
Retrospective immunization rate data
Large gap is that private clinic that give vaccine at least 50% do not use
MIIC Medical providers that do not give any vaccine
Identify and analyze quarterly the number of clinics who are participating in
MIIC and total number of county residents who have a MIIC record. Some
health systems information (Park Nicollet) is not separated by clinic and
county which prevent accurate analysis of immunization trends in our
county.
Douglas County is a part of MIIC. Our gap has been the lack of clinic
participation and not having adequate data to assess. Alexandria clinic, one
of our largest clinics, is now on MIIC and in 2006 our goal is for Broadway
Medical, another large provider, to get into the MIIC system.
Reviewed MIIC reports for immunization clusters.
contacted all Amish residents to obtain an immunization history
Flu vaccine supply issues, providers reluctant to give out FluMist, more
children being immunized for flu, more providers on immunization registry,
providers are not doing recall/reminders for immunizations since switching
to computer and MIC system
Many local providers are reluctant to use new combo vaccines; providers
are concerned about the complexity of immunization schedule
Casa and IPI visits
MMR rates lower in toddlers - notified clinic imm. staff and day care
providers.
11
CHB/County/City
Kandiyohi
Koochiching
Lake
McLeod
Mille Lacs
Morrison
Mower
Nicollet
Olmsted
Otter Tail
Pennington
Pine
Polk
Pope
Red Lake
Redwood Renville
Rice
Scott
Sibley
St. Louis
Stearns
Stevens Grant
Traverse
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
Todd
Wadena
Waseca
Draft June 22, 2006
Local immunization trends or gaps
Started Reminders again in 2005, should help rates which dropped when
switched to MIIC system and couldn't do reminders. DTP#3-88%, Polio#393%, MMR#1-93%, HiB#3-93%, HepB#3-94%, Varicella-85%, Prevnar#387% Prevar#4-56%
retrospective kindergarten study
Through MIIC and Community Health Board Planning Process
Working with clinics to get shot data onto MIIC in a timely manner to
decrease unneeded shots
We participate with other organizations as Mille Lacs Academy in
identifying immunization gaps. We monitor the reports we receive from
MDH on the schools and day care total immunization rate reports.
Worked with flu vaccination shortage.
78% of two year olds adequately vaccinated in Mower County in 2004
Data through IMMTRACK
Influenza immunization levels have increased.
MIIC saturation rate, Amish Community
Looked at CCC data for immunization levels for age groups
Volunteer Firefighters at increased risk for Hep-B due to job type. Need for
tetanus boosters in farm community and for blue collar workers or people
who work outdoors.
Immunization rates improving. C&TC rates improving.
Missed opportunities for immunizations. Children falling behind with
scheduled primary immunization series but being caught up at kindergarten
entrance.
Looked at CCC data for immunization levels for age groups
Done through MIIC reporting and school health records
Child day care immunization data shows an ongoing need to remind
providers to update immunization records as children receive additional
shots.
IPI visits
Overall immunization rates for Sibley County using MIIC
Nursing Homes having trouble accessing flu vaccine.
Trend: Stearns County continues to have small groups of people who fall
behind on their immunizations despite adequate resources.
IMMUNIZATION REGISTRY DATA
Lack of flu vaccine to health care providers. Survey done by Ph and
collaborated for a more equitable distribution to our providers. Created a flu
buying compact for 2006.
1. There continues to be a slow, gradual improvement in the immunization
goals for 0-24 months of age. 2. Amish community’s population have
increased significantly in past two years. Low immunization levels in this
population.
-Needed low cost access to HIB -Continued need for low cost access to
HepB for volunteer first responders, students and jail inmates.
1 year immunizations given too early; 18 month shots given late
12
CHB/County/City
Washington
Watonwan
Wilkin
Winona
Wright
Local immunization trends or gaps
Steady decline in number of people coming to our public immunization
clinics. Increasing number of private providers participating in MIIC.
Decreasing number of influenza vaccinations due to vaccine distribution
issues.
Reviewed immunization history of Pertusis cases.
Through assessing the information in MIIC, it appears that about 22% of the
children are behind getting their MMR according to the recommendations.
There is a dip in children up to date with Hib which is probable reporting of
Pedvax as hibtiter by one of the local clinics. Sany Macziewski, from our
Regional Registry is working with this clinic.
When called by MDH about the Amish polio outbreak in September 2005,
all local Amish families (300 persons) were contacted. All willing took the
polio vaccinations; however they were already at 90% or better due to
providing basic immunization to them since the mid-1980 . This
partnership work was multi-county, regional and statewide.
In 2005, student nurse interns surveyed rates of immunization in child care
centers and shared this information with MDH.
7) Give an example of a high-risk group that has been targeted to prevent the spread of infectious diseases.
Describe the group, disease(s), and the approach/service/activity.
CHB/County/City
Aitkin
Anoka
Becker
Benton
Bloomington Edina
Richfield
Draft June 22, 2006
Example of services to high-risk group to prevent the spread of
infectious diseases
Aitkin County has targeted the spread of sexually transmitted infections
among teenagers. We conduct interactive STI/HIV/AIDS presentations in
the McGregor 8th grade health classes and AIDS/STI and Family Planning
classes in the McGregor 10th grade. Our video "The Truth About Sex" is
loaned to Aitkin High School each quarter for 9th grade health. Each Fall
Public Health conducts "Which Star Is Yours" retreat for 8th grade girls and
each spring it conducts Charting Your Course workshop for 8th grade boys.
The purpose of these workshops is to get young people to think about ho0w
their choices they are making now will affect their opportunities for their
futures. Much of the discussion is about sexuality issues. For example, if
they get pregnant now, they might not get to go to college. If they contact
Chlamydia and don't know it, they might not be able to conceive children. If
they contact herpes, they may have a tougher time in the dating world and
in finding a spouse who is willing to cope with the disease.
Primary screening for recently arriving refugees. Individuals requiring
LTBI. Katrina survivors residing in Anoka County.
teen population and increase in STD's; need identified for local public
health to work within schools to educate.
Peri-natal Hep B We provided prophylaxis and case management to infants
born to Hep B pos moms.
Persons over 65 and those with chronic diseases such as diabetes, heart and
lung conditions, were deemed high-risk for influenza. Those persons
received the first doses of flu vaccine. Clinics were held specifically in the
community at senior centers and assisted living facilities to provide flu
vaccine.
13
CHB/County/City
Blue Earth
Carlton
Carver
Cass
Clearwater
Cook
Cottonwood
Jackson
Crow Wing
Dakota
Douglas
Faribault Martin
Fillmore
Goodhue
Hennepin
Houston
Kanabec
Kandiyohi
Kittson
Koochiching
Lake
Draft June 22, 2006
Example of services to high-risk group to prevent the spread of
infectious diseases
School children were sent home with Pertussis information sheet during
outbreak. Working with college health center to be more aggressive with
LTBI medication in international student population.
Hand Washing Education, Immunizations - New Moms
Beginning in 2004 and throughout 2005 Carver County Public Health
developed and implemented a Hepatitis B program in the Carver County
Jail. The program vaccinated inmates, a population with many risk factors
for Hepatitis B, with vaccine from the MDH's Viral Hepatitis B Integration
program and the Minnesota Vaccine For Children program. In addition to
vaccinations the program also conducts risk assessments, provides
education about hepatitis, HIV, and STI s and referral to other community
resources upon release.
Nursing home residents were targeted to receive the Influenza vaccine in
the fall of 2005. Vaccine was provided to the area nursing homes.
Amish community High risk groups for influenza
General Public - Hand Washing
New Somali residents all diseases get them immunized, to a physician and
follow-up on outcome.
Pre-schoolers receiving their varicella at an early age - 12 mos Law
enforcement receiving their Hep B. shots
None
Identified the adults population with needs for Hepatitis, Mantoux, and TD particularly through businesses, fire fighters, and first responders. Planning
began in 2005 and in 2006 will implement adult immunization clinics.
None
Amish - polio - offered polio immunizations to all Amish in their
community teens - STD - gave educational programs at schools
Seniors - Influenza vaccine given on-site at senior apartments, assisted
living, nursing homes, senior health fairs Foreign born employees of
industry in Red Wing - provided Hepatitis B shots onsite
LEP residents of Hennepin County present a potentially significant obstacle
to controlling a wide range of infectious agents
TB screening in county correctional facility
Adolescents were targeted and identified for vaccination status for Hepatitis
B. At risk students were provided opportunity for in school immunization
clinics.
Refugees: We provide refugee health services including immunizations, TB
screening, referral assistance in working with local civil surgeons for health
evaluations.
High School Seniors in the county are offered and encouraged to receive
meningitis vaccine prior to attending college and dormitory living.
TB, incarcerated jail pop
School District populations, WIC Program; Head Start Program; ECFE;
Fairs and Community Partners
14
CHB/County/City
Example of services to high-risk group to prevent the spread of
infectious diseases
Pope
Red Lake
Immunization clinics provided to children and adults targeting
underinsured/uninsured to prevent spread of vaccine preventable diseases.
Influenza mass immunization clinics provided to all ages (targeting the high
risk groups).
Foreign born (Somali and Hispanic)for TB - Screening , Contact
investigations, Case Management and Follow-up Women having given birth
in the last 12 months - Parinatal HepB - Vaccine administration and Followup
Adolescents-STD Education, Infants & Toddlers-Immunizations
Inmates at the county correctional facility receive 1 on 1 STD/HIV
education by the correctional health nurse; STD education is provided to
middle and high school students as a part of the health class curriculum
Academy-meningococcal
African American young men/ STD/ street outreach, on-spot specimen
collection, clinical services/ young men's sexuality groups.
Children -vaccines (outreach teachings), Day Care Consultations (teachings,
consultation), Consultation with homeless shelter (teaching, consultation)
Teens and Young Adults have received education and teaching on the use
of condoms. This group has also been targeted to receive Hepatitis B
Vaccination.
Increasing percentage locally of immigrants where Tuberculosis is endemic.
Services used : home visits, direct observational therapy, interpreter
services
Adolescents-STD Education, Infants & Toddlers-Immunizations
All primary refugees were screened in our public health clinic for TB,
HBV, parasites, and other infectious disease. All TB cases are now seen in
the TB clinic.
The high- risk groups are the Amish and Refugees. Our agency vaccinated
some of the Amish community for Polio and we perform INH therapy for
the refugees that have TB
n/a
Jail inmates at an increased risk for tuberculosis due to close confinement.
Each inmate receives a mantoux test within 14 days of incarceration. Low
income, non-insured or underinsured families at risk of not receiving
scheduled immunizations. Immunizations are provided through MNVFC
program free of charge. Hep-B vaccines offered to volunteer Firefighters in
Pine County at Immunization clinics. Adult tetanus vaccines offered at the
Pine County Fair.
Adolescents: school talks, "Safer Choices" curriculum provided in many
County school districts to 8th, 9th, 10th graders.
Pre adolescents (6th grade diseases-MMR, HEP B Td, Measles. Providing
school based clinics as a method to immunize a captive audience.
n/a
Redwood Renville
gave flu shots or diverted vaccine to where needed
LeSueur
Lincoln Lyon
Murray Pipestone
Mahnomen
Meeker
Mille Lacs
Minneapolis
Morrison
Mower
Nobles Rock
Norman
Olmsted
Otter Tail
Pennington
Pine
Polk
Draft June 22, 2006
15
CHB/County/City
Rice
Scott
Sherburne
St. Louis
St. Paul-Ramsey
Stearns
Steele Dodge
Todd
Wadena
Wasbasha
Waseca
Washington
Watonwan
Wilkin
Winona
Wright
Draft June 22, 2006
Example of services to high-risk group to prevent the spread of
infectious diseases
Parents whose primary language is not English and who have children in
need of immunizations. Rice County Public Health offers immunization
clinics in Faribault and Northfield; staff assess immunization status and
make referrals through WIC and on home visits; information distributed in
English, Spanish, and Somali regarding how to obtain shots in Rice County.
Newly arriving refugees Refugee Health Assessment Immigrants with class
B TB conditions Referral for evaluation and follow up ESL Class Education
as requested Daycare providers ECFE group
Gay men using a rest stop for anonymous sex. The MN AIDS project was
contacted to provide education and information was posted. The Nursing
Home population was targeted related to flu vaccine. Our vaccine was
redistributed to the nursing homes for their use.
Elderly - flu vaccine promotion. Nursing Homes -Assisted in making flu
vaccine available. Children (WIC and MCH Home Visiting) - Promote
immunizations. Cover Your Cough Campaign.
Pertussis Grant
Foreign born immigrants with TB identified through Refugee Health
Assessments by local providers or DHS. Service = home visits for active
and latent TB cases.
Foreign born residents-assigned staff for inc. consistency and competence.
Walk in clinics, more follow-up and referral to other providers.
Amish population - 5 clans, estimate 500 people. Polio outbreak October
2005. Each Amish household was visited for polio surveillance, contact
investigation and vaccine education and administration. Local MD and a
local midwife are providing vaccine education/outreach/administration to
Amish and referral to Todd County Public Health nurses for follow-up.
Jail inmates - HepB - Education and free HepB vaccine from outdating
MDH supply.
Day care providers were provided in-service education on basic prevention
of common childhood illness, and on monitoring vaccinations in their
daycare child and need for exclusion if not current
young adults, ages 13 to 21 - HIV/STDs - purchased teaching models and
developing an education plan.
Adolescents and adults have been targeted in both the school and health
care settings to increase early recognition, diagnosis and treatment of
pertussis.
Mom's group and MCH home visits. Education for moms with young
infants who have not received Pertusis vaccination. Provided information
on how to reduce the risk of contracting Pertusis.
No special group has been targeted.
See above in item #6
We had a local outbreak of Pertussis in the Maple Lake School District.
School nurses, administrators, parents, and students received education and
protocol for protection of transmission and staying home from school. Local
physicians were not familiar with current practices for testing, diagnosis,
treatment and prophylaxis. Public Health provided in servicing to specific
local clinics.
16
8) The public health department provided correctional health services.
•
•
49 entities responded yes (64%)
28 entities responded no (36%)
CHB/County/City
Anoka
Beltrami
Blue Earth
Brown
Carlton
Carver
Cass
Chisago
Clearwater
Cottonwood
Jackson
Dakota
Douglas
Freeborn
Goodhue
Hubbard
Isanti
Itasca
Kanabec
Kandiyohi
Kittson
Lake
LeSueur
Mahnomen
Marshall
McLeod
Meeker
Mille Lacs
Mower
Nicollet
Norman
Olmsted
Pennington
Pine
Polk
Redwood Renville
Rice
Roseau
Scott
St. Paul-Ramsey
Draft June 22, 2006
Most common infectious diseases being seen
Influenza, MRSA, STI/STD
HIV
STI's
sexually transmitted diseases foot fungus/athletes' foot
Herpes
Do not have 2005 data.
STD's
only minor colds
STD's LTBI
Inmates at not usually at our facilities to identify infectious disease, but the
most common thing seen is LTB.
No data system in place to gather the data.
Colds/Flu/Respiratory
Hepatitis B, Hepatitis C, STI/STDs
LTBI, influenza, upper respiratory infections, Hepatitis C & B
none trended.
Herpes simplex, Chlamydia
inmates / TB / mantauxs
Common cold and STD's
Hepatitis C + B, Chlamydia, Gonorrhea, STDs, HIV
Hepatitis C
Via contract with SuperiorHealth Community Care
Not many calls related to infectious diseases - more meth related illnesses.
Occasional STD and viral type illnesses.
TB testing
Common cold
13 inmates seen, infectious disease not known; scabies last year only; STD's
- 6 inmates seen, specific STD not known
Hepatitis C, Chlamydia
MRSA colds
We only do Mantou screening on qualifying inmates and jail staff. We are
seeing greater numbers of Latent TB in the corrections system.
Rashes, fungus
TB Testing
Chlamydia is most common. No outbreaks were reported. Medical/nursing
services are provided by Public Health.
STDs, HCV
STD's
Hepatitis B and C. STD's
influenza, upper respiratory
Rice County Public Health does Mantoux testing at the Rice County Jail.
Common cold
Staph Infection(not MRSA or Vanco resistant)
Chlamydia, Gonorrhea
17
CHB/County/City
Stearns
Steele Dodge
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Medicine
Wadena
Washington
Watonwan
Winona
Most common infectious diseases being seen
LTBI every month Stearns County is seeing 3-7 positive results from
Mantoux tests
Contracted to cover for a vacation only but discussed with primary nurse
and states HCV.
TB
HepC; strep; staph; abscessed teeth; ear infections. We saw one positive
HIV.
Chlamydia and other non-reportable STI's.
TB
One TB and one HIV
MDH will provide data for questions 9, 11- 17.
9) Total number of persons with newly-identified active TB disease (pulmonary and extrapulmonary) (i.e.,
incident cases) identified in jurisdiction last year.
11) Total number of newly-identified TB cases in jurisdiction last year for whom a TB contact investigation
was indicated*.
12) Total number of TB contact investigations in which at least 3 close contacts were identified.
13) Total number of close contacts of new cases identified.
14) Total number of close contacts of new cases who were evaluated* for TB disease or latent TB infection
(LTBI).
15) Total number of infected close contacts that were placed on treatment for LTBI.
16) Total number of primary refugees and immigrants with TB Class B Conditions identified overseas that
arrived in jurisdiction last year.
17) Total number of TB Class Bs that were evaluated for LTBI and TB disease.
*See Controlling the Transmission of Tuberculosis in Your Community: Performing Effective TB Contact
Investigations, MDH TB Prevention and Control Program, 2002, page 6.
Answers for questions 10, 18 and 19 are in the below table.
10) Total number of newly-identified TB cases the public health department started on DOT:
18) Total number of persons newly identified in the past year with LTBI being monitored for compliance and
completion of therapy:
19) Total number of persons previously identified with LTBI being monitored for compliance and completion
of therapy:
Newly identified
TB cases on DOT
(Q10)
Number of entities that
responded
Number of entities with
no data
Mean
Std. Deviation
Minimum
Maximum
Total
Draft June 22, 2006
Newly identified
LTBI cases being
monitored (Q18)
Previously identified
LTBI cases being
monitored (Q19)
65
69
61
12
3
12
0
90
204
8
29
109
0
744
1994
16
13
46
0
331
822
18
Summary Analysis of
Protect Against Environmental Health Hazards
In the area of Protect Against Environmental Health Hazards, all 77 reporting entities (including counties,
cities and multi-counties) did at least one activity/service from the following list of activities/services*:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Surveillance
Disease and other health
investigation
Outreach
Screening
Case finding
Referral and follow-up
Case management
Delegated functions
Health teaching
Counseling
Consultation
Collaboration
Coalition building
Community organizing
Advocacy
Social marketing
Policy development
Policy enforcement
* Definitions for the activities/services can be found at:
http://www.health.state.mn.us/divs/cfh/ophp/resources/docs/ph-interventions_definitions.pdf
1) The public health department (entity) provided at least one activity/service related to the below topics:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Ambient/Outdoor Air: 42 entities provided at least one activity/service (54%)
Indoor Air: 59 entities provided at least one activity/service (77%)
Radon: 68 entities provided at least one activity/service (83%)
Environmental Tobacco Smoke: 75 entities provided at least one activity/service (97%)
Daycare Establishments: 54 entities provided at least one activity/service (70%)
Lead: 75 entities provided at least one activity/service (97%)
Lodging and Residential Facilities: 42 entities provided at least one activity/service (54%)
Manufactured Home Parks: 40 entities provided at least one activity/service (52%)
Mold: 71 entities provided at least one activity/service (92%)
Recreational Camps and Youth Camps: 42 entities provided at least one activity/service (54%)
Animals/Pests/Vectors: 68 entities provided at least one activity/service (83%)
Clandestine Drug Labs: 70 entities provided at least one activity/service (91%)
Garbage/Junk House: 68 entities provided at least one activity/service (83%)
Food Service: 53 entities provided at least one activity/service (69%)
Grocery and Convenience Stores: 32 entities provided at least one activity/service (42%)
Consumer Food Safety: 51 entities provided at least one activity/service (66%)
Hazardous Waste: 42 entities provided at least one activity/service (54%)
Hazardous Materials: 40 entities provided at least one activity/service (52%)
Solid Waste: 37 entities provided at least one activity/service (48%)
Draft June 22, 2006
1
•
•
•
•
•
•
•
•
•
•
Individual Sewage Treatment: 49 entities provided at least one activity/service (64%)
Public Pools, Spas: 43 entities provided at least one activity/service (56%)
Lakes, Swimming Beaches: 43 entities provided at least one activity/service (56%)
New Water Well Construction: 45 entities provided at least one activity/service (58%)
Water Well Sealing: 46 entities provided at least one activity/service (60%)
Private Well Testing: 58 entities provided at least one activity/service (75%)
Non-Community Water Supplies: 42 entities provided at least one activity/service (54%)
Plumbing/Water Distribution Systems: 34 entities provided at least one activity/service (44%)
Body Art: 45 entities provided at least one activity/service (58%)
Tanning Beds: 28 entities provided at least one activity/service (36%)
2) The public health department referred calls about environmental health hazards to the appropriate
resource/organization/agency.
•
76 entities responded yes (99%)
3) If needed, the public health department provided materials in languages other than English.
•
•
•
30 entities responded yes (39%)
7 entities responded no (9 %)
40 entities responded not needed (52%)
List of materials and languages:
Spanish, Chinese. Fact sheets and posters.
Lead – Spanish
Provide food safety classes in English and Spanish to food service workers
Food safety information-Spanish, Chinese Certified Food Manager exam-Spanish &
Chinese
Carver County Public Health (CCPH) has the following brochures in Spanish: A Clean
Home is a Healthy Home, Cockroaches, Insect Safety, Prevent Lead Poisoning with
Food, Environmental Risks, EPA-Lead Poisoning & Your Child, What is Lead
Poisoning? CCPH has the following videos: Treating Head Lice - Hmong, Sesame Street
Lead Away - Spanish, Reducing Lead in the Home - Spanish. CCPH has the ECHO
productions in Hmong, Vietnamese, Khmer, Laos and Somali which include topics like,
Household Poisons and Fire and Carbo Monoxide Safety.
Used materials from other resources when available. Did not develop any.
Minnesota Food code Fact Sheets - various languages; Food Workers Emg Preparedness
Manual – Spanish
Spanish and Chinese educational food safety handouts
Lead- Spanish and Somali Food Safety- Spanish, Somali and Mandarin
Food Safety, Rental info, mold: Spanish
Spanish and Chinese
Landlords and Tenants: Rights and Responsibilities in Spanish
Smoking ban signage, food preparation manual.
Food code fact sheets in Spanish and Chinese
Information on Mold
Draft June 22, 2006
2
List of materials and languages:
Food Safety Information Spanish, Chinese Certified Food Manager Exam Spanish,
Chinese
Lead education materials from MDH in Spanish, Lau, Vietnamese
Handwashing Poster: Spanish, Cambodian, Vietnamese, Somali, Hmong, Chinese;
Illness Poster: Spanish, Chinese; Bed Bug: Spanish; Food Safety: Spanish
Food Safety - Chinese
When available thru MDH, Extension, etc. Hmong & Spanish
Written materials regarding radon in Spanish and English; written materials regarding
lead in Spanish, Somali, and English.
Did not list materials
Food handling educational material.
In Spanish, Hmong and Somali: Household hazardous waste, Radon myths and facts,
Reduce junk mail, Radon test kit instructions, Radon recorded message, Radon an
invisible hazard ad In Spanish and Hmong: Household hazardous waste recorded
message, Yard waste recorded message, Food safety In Spanish: Hazardous waste FAQ,
Cleaning schedule, Radon test kit letter, Radon test kit reminder, Emergency guide for
food managers
When available forms/brochures/materials are provided most often in Somali,
Vietnamese, and Spanish. Food Safety Information Handouts were provided for workers
in Chinese at a Chinese restaurant.
Flea/Cockroach info in Spanish
Spanish - lead. Food code fact sheets - Spanish and Chinese.
Food and solid waste fact sheets in Hmong, Spanish and Chinese.
Lead Information - Hmong & Spanish Food Services & Training - Spanish & Chinese
4) Describe any emerging environmental health issues in the community that were identified during the past
year.
CHB/County/City
Anoka
Becker
Beltrami
Carlton
Carver
Cass
Clearwater
Cottonwood Jackson
Dakota
Douglas
Draft June 22, 2006
Emerging EH issue
Community development adjacent to disposal sites. Food Safety
- Emergency Preparedness.
increased number of meth houses, mold complaints
Mold
Initially emerged as indoor air quality of home located near
industry which became an issue of defective lab testing and
involved multiple agencies.
Water quality issues in rural sewer systems, the effect of
prescription drug disposal on surface and groundwater, and the
need to increase the awareness/use of renewable energy and
"green" construction practices.
Methamphetamine-decrease in labs
Meth Lab's and debris hazards
Garbage homes Meth Contamination of homes and water supply
Water quality - Hatings Lead battery casings - child lead
exposure
Manufactured home parks with unapproved and/or grossly
inadequate storm shelter or evacuation plans
3
CHB/County/City
Edina
Fillmore
Houston
Isanti
Itasca
Kanabec
Lake
LeSueur
Mahnomen
Meeker
Mille Lacs
Morrison
Mower
Norman
Olmsted
Otter Tail
Pine
Polk
Pope
Rice
Roseau
Scott
St. Louis
Stearns
Steele
Stevens
Swift Big Stone
Chippewa Lac Qui
Parle Yellow
Draft June 22, 2006
Emerging EH issue
Community Health Committee identified mental health, obesity,
drug abuse, and senior health as issues
mold calls increasing
Meth, Septic system non-compliance
Meth Lab Cleanup Tattoo Parlors
Coal gasification plan potential
Blue-green algae toxicity in local lake.
Finland Air Base; asbestos and other air related concerns.
Meth labs
Meth labs
Increased number of calls regarding dead birds callers
requesting disease information and instructions on what to do
with the bird; complaints of potential mosquito reservoirs
meth and increased mold complaints in homes
Tattoo parlors/body piercing
Clandestine (meth) lab
Meth labs
Sale of methamphetamine precursors; children's environmental
health; goose flock/feces and avian influenza; cyanuric acid in
indoor pools.
Exotic Animals
Homes that may have been the site of meth labs, but were not
discovered by law enforcement. Realtors are trying to sell them,
but do not have any information on whether or not there was
meth lab activity, since there was no arrest on the property. In
addition, there have been more reports of homes that landlords
have rented out which may have been previous sites of meth lab
activity, but which were never discovered by law enforcement.
The tenants have developed respiratory problems. Another
problem has been with homes that citizens have rented that have
mold. Landlords are reluctant to do anything about the mold
problem, so the renters move out and the landlord re-rents the
home. People have been developing respiratory problems from
the mold.
Meth labs
Manufactured home parks with unapproved and/or inadequate
storm shelter or evacuation plans
In part because of the outreach done by Rice County Public
Health, there is an increasing awareness of radon as a health risk.
Methamphetamine, Mold
Clandestine Labs
Methamphetamine
Methamphetamine Lab clean up
Issues surrounding large hog operations and feedlots. Increase in
Public Health nuisance complaints.
CLANDESTINE LAB
IAQ concerns with unidentified source, feedlot issues, and bird
flu
4
CHB/County/City
Medicine
Todd
Wadena
Washington
Winona
Emerging EH issue
Liquid manure spill into a lake that has a public beach.
800 rats at an abandoned grain mill within city limits. The
property is on railroad land with a $180,000 HUD loan and no
one wanted to take responsibility. The mill had a major water
roof leak and grain in the basement. Estimates to tear it down are
$170,000+.
Perfluorochemical (PFC) contamination in groundwater. High
radon levels in Cottage Grove.
Retention Ponds Vector Control
Tabulated Summary of Emerging EH
Issues
Meth
Mold
Water quality
Pests/rodents/vectors
Indoor air (includes radon)
Sanitation
Air quality
Body art (tattoo)
Environmental justice/sustainable
development
Feedlots
Hazardous materials/waste
Mobile home/recreational park
Animals
Food
Garbage house
Other
Pools
Public health nuisances
Number of entities that responded
19 (25%)
6 (8%)
6 (8%)
5 (6%)
4 (5%)
3 (4%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
5) The county/city has written policies and procedures for addressing public health nuisance complaints.
•
56 entities responded yes (73%)
6) The public health department has written policies and procedures for implementing the removal and
abatement of public health nuisances specified in Minn. Stat. 145A.03 Subd. 8.
•
•
•
47 entities responded yes (61%)
28 entities responded no (36 %)
2 entities responded unknown (3 %)
Draft June 22, 2006
5
7) Number of complaints alleging public health nuisances:
•
55 entities responded (71%)
Minimum
0
Maximum
246
Average
27
Std.
Deviation
45
8) Number of complaints that the health department provided education/consultation over the telephone:
•
38 entities responded (49%)
Minimum
0
Maximum
100
Average
13
Std.
Deviation
20
9) Number of complaints that were referred to another agency to resolve:
•
42 entities responded (54%)
Minimum
0
Maximum
129
Average
8
Std.
Deviation
21
10) Number of complaints that meet definition for a public health nuisance:
•
48 entities responded (62%)
Minimum
0
Maximum
100
Average
8
Std.
Deviation
16
11) Number of public health nuisance inspections:
•
52 entities responded (68%)
Minimum
0
Maximum
142
Average
18
Std.
Deviation
31
12) Number of public health nuisances sites confirmed during 2005 (this is an unduplicated number):
•
53 entities responded (69%)
Minimum
0
Draft June 22, 2006
Maximum
100
Average
7
Std.
Deviation
16
6
13a) Number of confirmed public health nuisances sites in the process of abatement:
•
57 entities responded (74%)
Minimum
0
Maximum
20
Average
1
Std.
Deviation
3
13b) Number of confirmed public health nuisances sites abated*:
•
57 entities responded (74%)
Minimum
0
Maximum
90
Average
6
Std.
Deviation
13
*This includes confirmed public health nuisances that may not have needed abatement, but were resolved or no
action was needed.
14) Please list your top five areas of public health nuisance (PHN) complaints: (Note: some entities reported
more than one PHN as a top priority within a specific ranking. This means that the total number of entities
reporting is not necessarily a count of unique entities as some entities may have been counted more than once
because they reported more than one PHN.)
1st Public Health Nuisance (PHN)
garbage house
Mold
accumulation/source of filth/garbage
Meth
sanitation/septic/sewage
Animals
dilapidated buildings
pests/rodents/vectors
housing conditions*
other**
indoor air
water well issues
Total number of entities reporting
Unknown
Number of entities
reporting PHN
Percent
15
25
14
23
7
11
6
10
4
7
3
5
3
5
3
5
2
3
2
3
1
2
1
2
61
100
16
2nd Public Health Nuisance
garbage house
pests/rodents/vectors
accumulation/source of filth/garbage
Meth
Animals
Mold
Number of entities
reporting PHN
Percent
12
21
11
19
9
16
9
16
6
11
5
9
Draft June 22, 2006
7
2nd Public Health Nuisance
sanitation/septic/sewage
housing conditions*
water well issues
Total number of entities reporting
Unknown
Number of entities
reporting PHN
Percent
3
5
1
2
1
2
57
100
20
3rd Public Health Nuisance
pests/rodents/vectors
housing conditions*
accumulation/source of filth/garbage
Animals
Mold
garbage house
Meth
sanitation/septic/sewage
other**
dilapidated buildings
hazardous materials/waste
water well issues
Total number of entities reporting
Unknown
Number of entities
reporting PHN
Percent
11
22
7
14
5
10
5
10
5
10
4
8
4
8
4
8
3
6
1
2
1
2
1
2
51
100
26
4th Public Health Nuisance
accumulation/source of filth/garbage
Animals
Mold
indoor air
Meth
sanitation/septic/sewage
pests/rodents/vectors
dilapidated buildings
Feedlots
hazardous materials/waste
Pools
water well issues
Total number of entities reporting
Unknown
Number of entities
reporting PHN
Percent
6
16
6
16
5
14
4
11
4
11
4
11
3
8
1
3
1
3
1
3
1
3
1
3
37
100
40
5th Public Health Nuisance
sanitation/septic/sewage
accumulation/source of filth/garbage
Animals
pests/rodents/vectors
other**
Number of entities
reporting PHN
Percent
7
24
4
14
4
14
4
14
3
10
Draft June 22, 2006
8
Number of entities
5th Public Health Nuisance
reporting PHN
Percent
dilapidated buildings
2
7
Feedlots
2
7
indoor air
1
3
Mold
1
3
Pools
1
3
Total number of entities reporting
29
100
Unknown
48
*The category “housing conditions” contains the following responses: housing, lodging cleanliness, landlord
issues, safety issues-tenant complaints, increased blood lead levels, house odors, housing conditions, and
housing–mhp.
**The category “other” contains the following responses: food-borne, food and lodging, illegal burning, water
pollution, beaches, and unsafe conditions.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Tabulated Summary of Public Health
Nuisance (PHN) Complaints
garbage house
pests/rodents/vectors
mold
accumulation/source of filth/garbage
meth
animals
sanitation/septic/sewage
housing conditions
other
dilapidated buildings
indoor air
well issues
feedlots
hazardous materials/waste
pools
Total
Number of entities
reporting PHN
Percent
31
14
31
14
30
13
25
11
23
10
22
10
21
9
10
4
8
4
7
3
6
3
4
2
3
1
2
1
2
1
225
100
15) The county/city has an ordinance on: [check all that apply]
Ordinance
Smoke free park ordinances
Smoke free restaurant only ordinances
Smoke free restaurant and bars ordinance
Comprehensive smoke free workplace ordinance
Public health nuisance ordinance
Methamphetamine ordinance
Food, beverage and lodging ordinance
Solid waste ordinance
Other
Draft June 22, 2006
Number of entities with
ordinance
10 (13%)
5 (6%)
3 (4%)
6 (8%)
41 (35%)
51 (66%)
33 (43%)
38 (49%)
See below
9
Other ordinances summarized
sanitation/septic/sewage
mobile home/recreational park
tobacco
body art (tattoo)
mass gathering
swimming pools
water wells
hazardous materials/waste
lodging
feedlot
other
sex oriented business
water quality
animal control
food
public nuisance
recycling
vending machines
Number of entities with
ordinance
14 (18%)
11 (14%)
10 (13%)
8 (10%)
5 (6%)
5 (6%)
5 (6%)
4 (5%)
3 (4%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
16) The public health department gathered and reviewed the following drinking water information:
Drinking water information
Annual report on public water quality issued by the
public water utility(ies)
Test results on public non-community water supplies
(MDH/local public health department)
Test results on new private water wells (MDH)
Special studies done within jurisdiction on the quality
of drinking water
Other drinking water information
New mother private wells
private wells thru testing program
testing service for private wells
Water tests in special well construction area.
Number of entities that
reviewed information
10 (13%)
34 (44%)
9 (12%)
9 (12%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
17) The public health department did an analysis of drinking water data as part of its community health
assessment.
•
•
22 entities responded yes (29%)
55 entities responded no (71 %)
Draft June 22, 2006
10
18) The public health department did the following disease investigations:
Level of disease investigations performed
Assisted in and/or
Conducted case investigations into foodborne disease
outbreaks.
Assisted in and/or
Conducted case investigations into waterborne disease
outbreaks.
Number of entities
22 (29%)
17 (22%)
8 (10%)
5 (6%)
MDH will eventually provide the data for questions 19, 20 and 21.
19) Total number of foodborne disease case investigations (probable and confirmed).
20) Total number of waterborne disease case investigations (probable and confirmed).
21) Average number of foodborne illness risk factors per establishment for your jurisdiction.
22) Are there are any activities that the public health department did not perform in the above measures that are
being performed by other organizations?
•
•
•
53 entities responded yes (69%)
20 entities responded no (26 %)
4 entities responded unknown (5%)
Entity
Aitkin
Explanation
FBL and water testing by Aitkin County Env. Services Dept.
Beltrami
Food Beverage & Lodging MDH Delegation Agreement
Benton
Well inspections are done by our Zoning and Planning Dept.
MDH provides FBL, consumer food safety, recreational water. Independent
Household Hazardous Waste Collection Center - supported by county.
Outdoor Air activities - Sheriff department manages burning permits.
Food, Beverage and Lodging - Conducted by Minnesota Department of
Health
Food, Beverage & Lodging inspections are conducted by the MDH.
Waterborne and foodborne outbreak and case investigations are conducted by
the MDH. Carver County has an Environmental Services Department that
provides services related to Radon, Mold, Solid & Hazardous Waste
Management, Recreational Water and Drinking Water.
Cass County Environmental Services: Solid Waste, Sewage Treatment,
ground water, well location.
Chisago County Zoning and Environmental Services handles all septic
complaints
Blue Earth
Carlton
Carver
Cass
Chisago
Clay
Clearwater
Cook
Draft June 22, 2006
The Environmental Division under Planning and Zoning Department.
Well water testing, FBL, Manufactured Home Parks & Camps are handled by
MDH District Office
Minnesota Department of Health conducted Food, Beverage and Lodging
Inspections, Community and Non Community Water Well Programs
11
Entity
Cottonwood
Jackson
Crow Wing
Dakota
Edina
Fillmore
Freeborn
Goodhue
Hennepin
Houston
Hubbard
Isanti
Itasca
Kanabec
Koochiching
Lake
Lake of the
Woods
Lincoln Lyon
Murray
Pipestone
Mahnomen
McLeod
Draft June 22, 2006
Explanation
Cottonwood and Jackson Counties each have an environmental office that
works with well and septic systems, enforces the Nuisance and Meth
ordinance, solid and hazardous waste management, drinking water, well
sealing and well testing. Cottonwood County has a delegation agreement with
Brown/Nicollet for FBL and they report directly to the Cottonwood County
Board not the Board of Health.
MPCA - Outdoor air issues, CWC Planning & Zoning Department - Outdoor
garbage issues, land use issues (junk cars etc.)
Air Quality - MPCA; Daycare establishments & inspections - MDH; Food,
beverage, lodging - MDH; Food Safety - Dept of Agriculture; Manufactured
home parks - MDH; Youth camps - MDH; Solid Waste Management Physical Development Dept at Dakota Co.; Hazardous Waste ManagementPhysical Development Dept at Dakota Co.; Individual Sewage Treatment
Systems - Cities; Well construction/sealing -Physical Development Dept at
Dakota Co.; Plumbing-Water distribution - MDH
MDH oversees the well program.
zoning/SWCD do water testing, food inspections are done by MDH, meth
labs are also handled by DFO, zoning, FCSS, waste services
Environmental Services is a separate Department in Freeborn County. That
department handles a planning and zoning issues, regulates feedlots, septic
systems. Handles questions about private wells. Enforces the meth ordinance
and other activities. Food, beverage and lodging inspections are handled by
MDH.
MDH performs indoor air activities including radon, social services licenses
daycares, extension offers home food safety information, Goodhue County
solid waste is in charge of hazardous waste activities and hazardous materials
activities. Goodhue County Zoning department also assists in performing
some of the other measures identified.
Hennepin County Environmental Services provide services to deal with
hazardous waste.
Some activities are performed by individual cities, MDH also has a role in
some activities
Hubbard County Environmental Services
Zoning, MDH, Legal Aid
Environmental planning and zoning officer meth garbage houses law
enforcement - sheriff
MDH is responsible for these in our area.
Planning and Zoning; law enforcement
Septic System Inspections - Planning and Zoning Non-community Water Minnesota Department of Health (State) Campgrounds - Minnesota
Department of Health (State) Initial Plumbing Inspection - State
Food, beverage and lodging and water testing done by MDH
Septic Systems, Hazardous Waste and Solid Waste - being done by County
Departments
Regional Health Department
State-FB&L delegation; State-Drinking Water; State-Lead Abatement
12
Entity
Meeker
Mille Lacs
Mower
Norman
Olmsted
Otter Tail
Pine
Polk
Pope
Redwood
Renville
Rice
Scott
Sibley
St. Louis
Stearns
Steele Dodge
Stevens Grant
Traverse
Swift Big Stone
Chippewa Lac
Qui Parle
Yellow
Medicine
Explanation
FBL is done by MDH through a delegation agreement; drinking water
compliance and lead abatement completed by MDH
County and township zoning, MDH, soil and water conservation group
Public health nuisance complaints and investigations and well water testing
are done by Mower County Environmental Health Service.
Regional Department of Health
Solid/hazardous materials and waste; well construction/sealing; ISTS;
housing code; lead (MDH); indoor air (private consultants); ambient air;
plumbing code
Water Testing is done by Private Hospitals, Solid Waste Management and
Septic Systems are handled by another department within the county, and
Food/beverage/lodging is handled by MDH
Pine County Zoning Dept. takes care of solid waste issues and sewage issues
in rural areas.
Communities do their own water testing.
Solid waste, ISTS inspections, monitoring of lake quality and clarity
County Environmental Office handles hazardous materials and solid waste
issue
The Environmental Health Unit of Rice County's Planning and Zoning
Department conducts septic system inspections, follows up on and abates
public health nuisances, and facilitates private well water testing for Rice
County residents.
The EH Department is in another division in Scott County. That department
provides Radon outreach, hazard waste policy enforcement, hazard materials
outreach, solid waste policy enforcement, individual sewage policy
enforcement, and provides well testing.
Food, Beverage and Lodging Inspections by MDH Water testing completed
by local cities in the county Home Lead Assessments completed by MDH
Department of Agriculture; Minnesota Pollution Control Agency; Minnesota
Department of Health
Stearns County contracts with the City of St Cloud for Food, Beverage, and
Lodging Inspections; Minnesota Department of Health regulates the drinking
water activities; Minnesota Pollution Control Agency regulates the hazardous
materials activities.
Environmental Quality Committee deals with many of these issues in Dodge
Co. Environmental Health is a separate dept. in Steele Co.
FBL - STATE OF MN SHORELAND MANAGEMENT SOLID WASTE
MANAGEMENT
Todd
Hazardous waste program-County zoning handles New well constructionMDH Retail issues-MDA
Solid Waste Department, Planning and Zoning Department, Feedlot Officer MN PCA and Local Building Inspectors for activities related to Solid Waste,
Hazardous Waste, Individual Sewage Treatment, Wells and Plumbing.
Wasbasha
Solid waste management is done within the engineering dept.
Draft June 22, 2006
13
Entity
Waseca
Wilkin
Winona
Draft June 22, 2006
Explanation
Solid Waste and Hazardous Waste, Limited Outside Air - other county
agency; Plumbing in incorporated cities by city building official; MDA Groceries and Convenience Stores; Limited vector control - City of Waseca;
Clay County- FBL Inspections
Sewage & Septic Systems Ordinance - Winona County Planning & Zoning
Dept. Vector Control - LaCrosse Encephalitis and West Nile - LaCrosse Co.
WI contract
14
Summary Analysis of
Prepare for and Respond to Disasters and Assist Communities in Recovery
1) The public health department kept primary contact information updated with the MDH.
•
77 entities responded yes (100%)
2) The public health department updated the public health contact information in the local jurisdictions
Emergency Operations Plan (EOP).
•
76 entities responded yes (99%)
3) The public health department participated in assessment of local hazards and vulnerabilities.
•
67 entities responded yes (87%)
4) The public health department reviewed with emergency managers health/medical annex of the local
jurisdictions EOP.
•
66 entities responded yes (86%)
5) The public health department reviewed/updated the local public health department EOP.
•
72 entities responded yes (94%)
6) The public health department exercised a component of the public health department EOP.
•
70 entities responded yes (91%)
7) The public health department has trained appropriate staff in the National Incident Management System
(NIMS).
•
64 entities responded yes (83%)
8) The public health department has a system to notify, deploy and train agency workforce.
•
74 entities responded yes (96%)
9) The public health department tested the notification and deployment system.
•
67 entities responded yes (87%)
Draft June 22, 2006
1
10) The public health department tested the Local Health Alert Network primary and backup system at
least once.
•
74 entities responded yes (96%)
11) The public health department operations plan addresses how the department will communicate with
the media and public.
•
75 entities responded yes (97%)
Results
1) The public health department participated in a public health response to an emergency in the local
jurisdiction.
•
30 entities responded yes (39%)
CHB/County/City
Aitkin
Anoka
Becker
Public health response to an emergency
Electrical outage - mass shelter. Power restored before individuals relocated, but PH
participated in preparation to re-locate.
Coon Lake Beach e-coli response, March 2005 anthrax tabletop, September 2005
anthrax drill, December 2005 NIMS training for Incident Command Chiefs and Mass
dispensing site chiefs.
School bus and truck carrying chemicals collided. Hospital, clinic, emergency
management tested.
Benton
We participated in an exercise in which there were no actual PH responses.
Blue Earth
A tanker truck carrying anhydrous ammonia overturned on Hwy 169, going through
town. LPH worked with Mankato police to evacuate the effected neighborhood, and
assisted the local Red Cross with sheltering needs for those residents. LPH also
assumed responsibility for notifying local clinics and Emergency care of the event so
they would be prepared if there had been widespread exposure. LPH also notified
neighboring county LPH so they would be on alert.
Carver
Shigella outbreak at a local beach. Carver County Public Health (CCPH) was notified
by the MDH via the 24/7 contact notification system, of 6 children with severe
diarrhea & fever, who had swum at same beach on same day. The MDH requested
closure of beach. CCPH notified County Parks Department and facilitated immediate
closure of beach, along with posting signage. All relevant County contacts were
notified and the Disaster Response Action Team , including CCPH, MDH, County
Administration, Emergency Management and Parks was convened. All appropriate
parties were updated as information changed, i.e.: City of Chanhassen, Sheriff s
Office. CCPH, with County Administration, served as media spokesperson. The
beach was reopened, under the direction of CCPH and the MDH, through Parks
Department.
Draft June 22, 2006
2
CHB/County/City
Cass
Cook
Crow Wing
Dakota
Freeborn
Lake of the
Woods
Mahnomen
Mille Lacs
Morrison
Mower
Norman
Olmsted
Otter Tail
Roseau
Stearns
Steele Dodge
Stevens Grant
Traverse
Todd
Wadena
Wasbasha
Washington
Draft June 22, 2006
Public health response to an emergency
The public health agency was on alert to provide staff to Operation Northern Comfort
at Camp Ripley. As one of the counties bordering the Camp Cass would have been
called in to staff the barrack nurse function. Our staff was notified, through our call
up system, on Saturday night of Labor Day weekend and were ready to deploy as
soon as Sunday. We did not have to report to Camp Ripley, staff however helped by
supplying some of the needed forms and paperwork to those inside the Camp.
Alpine Lake Fire
Operation Northern Comfort (for Katrina Survivors) at Camp Ripley.
Formalized 24/7 on-call system and are notified by emergency management of all
incidences in the county that may have a health impact on citizens. Provided follow
up to a residence re: to the 04 Rosemount mercury spill and continue to provide
training to various disciplines re: our response and the associated health impacts.
Responded to an outbreak of viral meningitis at one of the high schools in the
County. Participated in a meeting of key community partners to plan for the
possibility of receiving Katrina evacuees into the community. Prepared to send staff
to Camp Ripley if needed to assist with Katrina evacuees.
County functional exercise with a suspected biological agent.
2005 Ice Storm/Power Outage
Hurricane Katrina incident
Operation Northern Comfort: September 2005
flooding, clandestine (meth) lab abatement
2005 Ice Storm/Power Outage
Several disease outbreaks in schools and restaurants.
June 20, 2005 responded to storm damage in Otter Tail City
Flood threat, Hurricane recovery
Anthrax Threat at the St. Cloud Times Newspaper: there was a letter with a
suspicious white powder on it, the shut-down was handled by the Hazardous
Material Team, Stearns County Public Health Team received the call from the
Stearns County Chief Deputy, within 20 minutes the Stearns County Public Health
Team was contacted and told that the powder tested negative for anthrax, MDH
contacted the local law enforcement.
Pertussis outbreak in a day care center Assistance during flooding
ICESTORM, POWER OUTAGE TRAVERSE COUNTY
In September 2005 responded to the request of the Central Region to have PHN/RN
staff ready for Northern Comfort Hurricane Katrina survivors for Camp Ripley.
October 2005 Polio outbreak: surveillance, contact investigation, education and
vaccination in Amish communities.
August-Triage SNS Regional, Staples September-Camp Ripley Response
Did a drill on suspicious package within the county courthouse system. Involved all
responders including law, fire, Public Health, county administrator
On Sunday morning, August 28, 2005, the City of Woodbury experienced a
malfunction in their municipal water supply system. This malfunction resulted in
sudden and severe loss of water pressure city-wide. Private houses and businesses
were without water supply. The public health department communicated with
licensed food establishments regarding safe operating procedures. We also
activated our emergency telephone notification system to communicate to homes
and businesses about the status of the incident. Over 20,000 telephone contacts
were made.
3
CHB/County/City
Public health response to an emergency
Wilkin
In November/December 2005, there was an ice storm which caused extensive
power outages throughout the county. The public health department provided an
emergency supportive role in this emergency situation. Public health staff contacted
all of the county township chairpersons to ask them to help identify residents in their
townships who may need assistance, i.e., food, medical attention, heat,
transportation. The public health staff contacted these individuals to offer assistance,
provide information and referral to resources needed.
Winona
Wright
Draft June 22, 2006
Sunday September 4, 2005 the local Winona Co. CHS agency was called to prepare
for Hurricane Katrina victims. We alerted key staff to be ready to respond if MDH
called. Tuesday September 5, after alerting all appropriate EMP partners and the
media, local leadership met to plan the exact logistics to relocate Hurricane Katrina
victims. Several meetings occurred for key leaders and this included a local faith
community that went to New Orleans and worked with us to bring up to 100 persons
to Winona County. The planning was well done, resources were determined
including housing locations, however no persons choose to come to Winona County
on a permanent basis. Nine persons were served as they traveled through the
County to other friends or families. The post meeting of all involved was held in
March 2006, to review lessons learned and to maintain the broad community
partners that are not core team EMP County members.
Pertussis outbreak in May 2005 and on-going. Mobilized to assist with Northern
Comfort although no staff was dispatched.
4
Summary of Analysis of
Assure the Quality and Accessibility of Health Services
1) In the most recent community assessment, the public health department identified gaps in health care services
or barriers to health care access in the following areas: [check all that apply]
Gaps in health care services/barriers to health care
access
Transportation
Lack of insurance
Uninsured
Underinsured
Uninsurable
Housing
Income
Basic life needs
Cultural competency of providers
Lack of providers. Specify type of provider.
Other. Specify.
Specified type of provider lacking
dental
mental health
child/adolescent psychiatrists
adult day care
home care
nurses
chore service
family planning
medical specialists
ob/gyn
physicians
primary care
psychiatrists
respite care
urgent medical care
arthritis services
behavioral aides
caregivers support
CDCS
chemical health
drug treatment
EMS
foster care
nursing homes
PCA
Draft June 22, 2006
Number of entities
that responded
62 (80%)
57 (74%)
55 (71%)
51 (66%)
21 (27%)
46 (60%)
44 (57%)
24 (31%)
23 (30%)
See below
See below
Number of entities
that responded
47 (61%)
20 (26%)
5 (6%)
4 (5%)
4 (5%)
4 (5%)
3 (4%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1
Specified type of provider lacking
pediatrician
psychologists
public health
refugee health screening
senior health
surgery
Other gaps in/barriers to health care
Dental
Dental services for low income persons and those on
Medical Assistance
Adult day care
Dental access
Fewer businesses offering full insurance
Hep B for jail inmates
Inadequate post acute/rehab beds in nursing homes.
Lack of access to and knowledge of community
resources and services.
Lack of exercise, Unhealthy eating
Mental Health Access
PCA services for children with challenging behaviors
Religious beliefs about some health care services
Smoking
subsidized family planning
Chemical Use by Youth
Inadequate facilities for those with heavy care,
complex medical needs and individuals with
challenging behaviors
Mental Health-specifically for children and 2) lack of
slots in DHS for CAC/CADI/TBI.
Systems issues: Changed eligibility for public
programs and decreased funding for outreach and
assistance in completing applications for state
programs through government or non-profit
organizations
Number of entities
that responded
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
Number of entities
that responded
2 (3%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
2) The public health department worked on addressing gaps or barriers in the following areas: [check all that
apply]
Gaps/barriers addressed by public health
department
Transportation
Lack of insurance
Uninsured
Underinsured
Draft June 22, 2006
Number of entities
that responded
40 (52%)
50 (65%)
46 (60%)
37 (48%)
2
Gaps/barriers addressed by public health
department
Uninsurable
Housing
Income
Basic life needs
Cultural competency of providers
Lack of providers. Specify type of provider.
Other. Specify.
Number of entities
that responded
16 (21%)
29 (38%)
17 (22%)
29 (38%)
21 (27%)
See below
See below
Lack of type of providers addressed by public
health department
dental
mental health
primary care
adult day care
family planning
home care
medical specialists
arthritis services
audiologists
behavioral aides
child/adolescent psychiatrists
chore service
EMS
nurses
optometrists
PCA
psychiatrists
respite care
urgent medical care
Number of entities
that responded
35 (46%)
7 (9%)
5 (6%)
2 (3%)
2 (3%)
2 (3%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
Other areas addressed by public health department
Resource directory
Child Psychiatrists
Number of entities
that responded
1 (1%)
1 (1%)
1 (1%)
Developed and distributed Aging Resource Guides.
Hep B for jail inmates
1 (1%)
Financial barriers, M.A. reimbursement, limitations for 1 (1%)
services.
Supported efforts to maintain eligibility criteria for
1 (1%)
public programs
dental care and access
1 (1%)
Dental
1 (1%)
Worked with the Northfield Community Action Center to 1 (1%)
secure and implement a dental services grant.
Smoking
1 (1%)
Dental
1 (1%)
Key Community Informants
1 (1%)
Draft June 22, 2006
3
Number of entities
Other areas addressed by public health department that responded
Supported efforts to increase funding for outreach (see 1 (1%)
question 1 above) and organized community group
(internal and external membership) to 1. Assure up to
date information on resources; 2. Be catalyst for creating
new resources and 3. Increase public awareness
Community Assessments
1 (1%)
3) Summary findings on the accessibility and quality of preventive health care services from the community
health assessment were shared with providers, stakeholders and the public.
•
60 entities responded yes (78%)
4) The public health department provided and/or contracted for the following public health services to fill a
health service gap or to coordinate/link people to services:
Case management programs:
AC: Alternative Care
CAC: Community Alternative Care (CAC) Waiver
CADI: Community Alternatives for Disabled Individuals
(CADI) Waiver
DD: Developmentally Disabled
Early intervention service coordination for children with
special health needs
EW: Elderly Waiver
MSHO: Minnesota Senior Health Options
MR/RC: Mental Retardation or Related Condition
(MR/RC) Waiver
TBI: Traumatic Brain Injury (TBI) Waiver
Other case management programs identified by
public health department:
Family Health
Freeborn County is a member of South Country Health
Alliance, a county based purchasing organization (the
managed care entity for MA enrollees in nine counties).
A Community Resource Management Team (CRMT)
leader is located in the PH Department and is funded by
SCHA. The CRMT promotes service accessibility and
promotes comprehensive coordination of all services to
meet the needs of SCHA members across the age
continuum. The team is responsible for the provision of
services to SCHA members including outreach,
information and referral, care coordination and
advocacy. The MSHO product for SCHA is called
Senior Care Complete. Other programs offered by
SCHA include MN Senior Care Plus and AbilityCare (a
Medicare program for persons with disabilities who are
Draft June 22, 2006
70 (91%)
57 (74%)
68 (88%)
28 (36%)
68 (88%)
71 (92%)
59 (77%)
31 (40%)
49 (64%)
1 (1%)
1 (1%)
4
Other case management programs identified by
public health department:
dually eligible for MA and Medicare.
Child Welfare Targeted Case Mgmt (TCM) Vulnerable
Adult Targeted CM; Relocation Services Coordination
(TCM)
Childhood lead poisoning case management
MCSHN
TBI – long term care assessments; social services
provides case management
All care community care and preventive care
coordination for South Country Health Alliance
members regardless of age
South Country Health Alliance
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
Clinics:
C&TC (Child & Teen Checkups) clinics
Family planning clinics
Foot clinics
Sexual transmitted infections (STI) clinics
TB (Tuberculosis) clinics
44 (57%)
28 (36%)
39 (51%)
17 (22%)
18 (23%)
Other clinics identified by public health department
Immunizations
WIC
PHN
Blood pressure
Senior
Mantoux tests and follow up
Immigrant/refugee
Underserved adult clinic
TB
Supplemental forms to I-693
School based
Lead screening
Diabetes
Community nurse
Cholesterol
Car seat
Birth to three evaluation
14 (18%)
5 (6%)
5 (6%)
4 (5%)
3 (4%)
3 (4%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
Outreach & Screening:
C&TC Outreach
Long Term Care Consultations
PCA: Personal Care Assistance (PCA) Assessment
Services
Draft June 22, 2006
74 (96%)
71 (92%)
72 (94%)
5
Other outreach and screening identified by public
health department
Interagency Early Intervention Committee
Health promotion – cholesterol, BP, diabetes
Community Social Worker
Dental van
Scoliosis, Hearing, Vision, Early Childhood Screenings,
Heights & Weights, Blood Pressure, Paternity,
Immunizations
Komen Screenings
medical assistance applications, OAE hearing screening
Lead in Homes
Early Childhood Screenings
Attend local health fairs. Network with Parish Nurses.
Distribute information via website and publications to
the public on available services.
Screening for Developmental Delays with school
personnel (ASQ-SE)
BP, cholesterol, diabetes, health promotion clinics
Early Childhood Screenings, Follow-Along Programs,
Communities Caring For Children
We are a host site for HIV testing; we contract with a
provider to offer smoking cessation classes; we contract
with a provider to offer prepared childbirth classes in
English and Spanish
Health screenings for risk status for all South Country
Health Members
Cholesterol, diabetes, blood pressure
EHDI Grant Activities
BP, Diabetic, Newborn Blood Screening
Community Resource Management Team Lead – LSW
Primary Care:
Dental care
Medical care—care from physician, physician’s
assistant, nurse practitioner
Other primary care identified by public health
department
Blood pressure, family planning, Sage, Sage Plus,
immunizations
Family Planning methods-purchased through clinics and
pharmacies
fluoride varnish and dental screening
Through our Family Planning Special Project, we
contract with local providers for family planning services
Medical Consultant for agency public health clinics
Draft June 22, 2006
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
9 (12%)
9 (12%)
3 (4%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
6
Services in the home:
Licensed home care
Licensed hospice care
Other services in the home identified by public health
department
PHN home visits
Assisted Living Programs
MCH prenatal/postpartum visits. Home visiting program
for at-risk families.
DOT, Intensive Family Home Visiting
Public Health Nurse Clinics
Family health home visits, Childhood lead poisoning
assessments and education
Homemaker Services- Registered with MDH
PCA Services
Family Home visiting in a universal newborn visiting
program and a Mom’s Program working with high risk
first time pregnant women through the child’s second
birthday.
Family Home Visiting
MCH services
Family Health
Services to special populations:
Correctional health
Refugee/immigrant health services
Linking to services
Providing services
Other services to special populations identified by
public health department
Vulnerable adult, early childhood intervention for
children ages 0-3
Paternity Testing and Drug Screening
Teen Parents
Mental Health
pregnant/parenting teens, hurricane Katrina victims, non
English speaking populations
Public Health Nurse resource manager to the enrollees of
South Country Health Alliance
Manitouxs only and evaluation to staff
DNA testing; DOT for clients with TB
Adults with mental illness residing in community;
linking to services and medication management
(providing service)
Nursing Services Juvenile Detention
DNA Testing for Social Services
Amish
Draft June 22, 2006
40 (52%)
7 (9%)
3 (4%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
50 (65%)
44 (57%)
45 (58%)
30 (39%)
3 (4%)
2 (3%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
1 (1%)
7
Other services to special populations identified by
public health department
Public Health Nursing Clinics for Mentally ill
1 (1%)
5) The public health department took actions to improve health care and health promotion services by making
them more culturally competent.
•
55 entities responded yes (71%)
Actions public health department took to improve health
CHB/County/City care/promotion by making them more culturally competent
Health educator provided session on biases/attitudes and effects to targeted
populations. Public health nurses utilize ECHO videos; non-English
speaking population at Even Start; ESL overview monthly presentation on
Anoka
resources; PHN provided health education
Provided more of our information in other languages. Now do the Follow
Along Program in Spanish. We offer a Spanish speaking nurse to our
Benton
Spanish speaking clients.
Bloomington,
Translated materials, bi-lingual educational presentations, and staff
Edina & Richfield training
Diversified staff, improving utilization of non-family interpreters,
Blue Earth
participation in diversity council
Brown
Dakota
translating materials, hiring an interpreter as needed,
Carver County Public Health actively participated in the ECHO program,
maintains contracts with interpreters and consistently uses them in
interactions with non-English speaking clients, has translated outreach and
educational materials into Spanish, created Immunization Clinic signage in
Spanish, and is continually seeking committee members that are
representative of the communities we serve.
Outreach was targeted to the Native American population for Senior
Clinics. Both adult and children s home care services are coordinated
with the Reservation. The county provides many services that the
Reservation Public health is not able to provide.
Developed access to more interpreter services
Steps toward continuing education for LPH, Home Care & Hospice nurses
In-service education to assist staff to understand different cultures they are
working with. Assist in the support of ECHO
- Increased number of interpreters in immunization clinics - Use
interpreter/language line for all clients when appropriate - Information
provided in print in most frequent languages; Spanish information on
website and telephone (immunization schedules, vaccine and flu
information, CTC, WIC) - Cultural competence training for staff Improved policy and procedures for interpreter use - Hiring diverse staff
(see Infrastructure) - Utilized the diversity intern trainee program in the
County - Contracted with community agency to do outreach to diverse
populations for CTC - Contracted with outreach worker focused on
tobacco prevention with Latino youth - Funded ECHO (Emergency and
Community Health Outreach) project for limited English populations
Douglas
WIC - CTC - Family Health
Carver
Cass
Chisago
Clearwater
Cottonwood
Jackson
Draft June 22, 2006
8
Actions public health department took to improve health
CHB/County/City care/promotion by making them more culturally competent
Encouraged use of translators by medical community and shared translator
Faribault Martin
list with medical community
Had to conduct mass polio immunization clinics in the Amish Community.
Fillmore
Did so in a way that was culturally acceptable to them with positive results.
Used interpreters as needed, purchased or translated materials into Spanish,
hired a bilingual/bicultural staff person, and organized a staff in-service on
Freeborn
Hispanic cultural information.
AT&T Language Line - use specifically for Family Health and at the jail.
Continued to contract with and utilize Spanish language interpreters. Three
Goodhue
public health staff took Spanish lessons
Hennepin
Hired and trained diverse staff
Hubbard
In-service
Contract with Language Line Use of Educational information in multiple
languages
Kanabec County does not, at this time, have many non-English speaking
families. We needed to use interpreter services 1 time in 2005. However,
we have taken actions to improve health care and health promotion
services for the culture of poverty in Kanabec county. We have a large
number of people with low socioeconomic needs.
2 Latino Bilingual Interpreters/Translators on staff, development of
contract for Somali Outreach staff, Language Line availability, provide
materials in Spanish and Somalia
Isanti
Kanabec
Kandiyohi
Lake
LeSueur
Lincoln Lyon
Murray Pipestone
Mahnomen
Marshall
McLeod
Staff training
ECHO tapes, Interpreter services for WIC clinics, Health brochures
available in Spanish
Exercised cultural awareness Served clients regardless of race, religion,
etc. Used interpreter services when appropriate Served Clients regardless
of the ability to pay
Spanish Materials
Some written educational materials available in Spanish
Mille Lacs
much of our information is available in Spanish
Written education materials translated into Spanish, reception/support staff
attended a Spanish language class, one PHN who continues to further her
Spanish language skills
We have only a few cases but materials are provided according to the
client's primary language. Interpreters provided as needed
Minneapolis
Interpreter and bilingual staff
Morrison
Alternative language material, working with interpreters
Advertising brochure for prenatal classes and young adult health clinic
translated into Spanish. Began discussing the need to hire an interpreter for
use in public health programs.
Interpreter forms were translated into Somali and Hispanic languages - TB
sheets the same
Interpreter services, Written materials in languages, Bulletin boards in
languages.
Used Pacific Interpreters interpreting services, have one nurse who speaks
Spanish, contracted with Lutheran Social Services for interpreters, and
Meeker
Mower
Nicollet
Nobles Rock
Otter Tail
Draft June 22, 2006
9
Actions public health department took to improve health
CHB/County/City care/promotion by making them more culturally competent
have ECHO tapes available in various languages
Made sure all staff are aware of the Limited English Proficiency (LEP)
standards; made sure brochures are available in different languages;
Pine
provision of interpreters if necessary.
Spanish brochures. Spanish Interpreter contract. Community meeting held
in July, 2005 with the Offices of Minority and Multicultural Health from
Polk
MDH. Meeting was held in Crookston.
Had bilingual homecare nurse oriented to parent/child/homevising to
Pope
provide service to Hispanic family
Translators, AHEC member-develop interrupter classes, culturally
Redwood Renville sensitive brochure developed
Actively worked with the HealthFinders Coalition in Rice County to
establish a free clinic, which is serving many persons whose primary
Rice
language is not English.
Hired a Bilingual C&TC Outreach Worker(English/Spanish)for prenatal
clients Purchased VHS/DVD for home visits Staff have attended Diversity
Training Public Health has continued to increase/update client education
Scott
materials in Spanish Planning to obtain Russian C&TC outreach worker
Translating appropriate material as necessary Providing an interpreter
Sibley
when needed
Conducted key informant interviews with populations of color and
St. Louis
American Indians to assess barriers to preventive health care.
-Recruiting, hiring, and retaining bi-cultural and bi-lingual staff (42% of
WIC staff are persons of color and 50% are bi-lingual). -Assuring
availability of language or hearing-impaired interpreters on all Family
Health home visits. -Development of multi-cultural posters promoting
Child & Teen Check-ups that were used across the metro. -Planning and
attending county-wide trainings featuring aspects of cultural awareness and
competence, e.g. Public Health Presents and Treasure Trove (Culture of
Poverty). -Sponsoring worksite seminars on topics such as Somali culture,
strengths, child spacing and family planning; communicating through
interpreters; population based health; and the Wakanheza program. Providing basic "western" lifestyle, health and safety information through
multi-lingual staff and materials. -Making translated education materials
(print, video) available in Spanish, Hmong, Vietnamese, Somali, and other
St. Paul-Ramsey
languages as needed.
Stearns County uses translated materials when available. Forms and
materials have been translated into Somali, Spanish, and Vietnamese.
Stearns County has a Limited English Proficiency (LEP) Plan and all
Human Services staff are annually trained on procedures for cultural
competency. Stearns County Human Services also has a Diversity
Committee in which the Public Health Division participates; in 2005, one
Stearns
Public Health staff member was co-chair of the committee.
Hired bilingual staff. Involved in Community organizing-Cultural
Diversity Network in Steele County. Frequent update and education for
staff in cultural competence. Better access and use of translated materials
Steele Dodge
and interpreters.
Staff who are bilingual assisted with Spanish speaking population with
Todd
their needs for Public Health services. Provided staff in-service regarding
Draft June 22, 2006
10
Actions public health department took to improve health
CHB/County/City care/promotion by making them more culturally competent
this.
Materials translated into several languages. Efforts have been made to
Washington
increase our interpreting capacity and translation of materials.
CHS agency has formed a partnership with local hospital/clinic and local
industry to hire a culturally and linguistically appropriate health educator
Watonwan
to improve outreach and access for our Latino population.
Winona County CHS Dept and Project FINE (local non-profit service
newcomers to Winona County) maintain a medical interpreter pool for
services to eligible PMAP- MSHO clients for thirteen languages. Hmong
and Spanish are the most needed languages to those who are learning
Winona
English.
6) The public health department assessed all clients (i.e., clients with a personal health record, including WIC
and correctional health) seen by public health staff for health insurance status.
•
•
55 entities responded yes (71%)
22 entities responded no (29%)
CHB/County/City Explanation for not assessing all clients for health insurance status
Benton
Carver
Cass
Dakota
Douglas
WIC is not required to check or record insurance status of clients.
We currently do not do assess all correctional health clients for health
insurance and we do not see WIC clients. We are looking at changing this
practice in the future. We do assess and refer all of our other clients.
Everything but correctional health. At booking, inmates are not assessed
for health insurance until a medical need arises.
Correctional health information is asked by Corrections staff but is not
part of the medical record (work is underway to develop electronic records
so no new system will be initiated to capture this information until
programming is completed).
In WIC clients are assessed as to whether they have MN
Care/MA/PrimeWest but are not asked if they have other insurance or are
uninsured.
Goodhue
Do for all except Correctional Health
Lake of the Woods Not done consistently with all clients
Marshall
Some but not all.
McLeod
not at immunization clinic
Minneapolis
Many, but not all.
Mower
all but correctional health
Olmsted
Pope
Have not assessed in WIC area.
Clients that had a case opened for services were assessed for health
insurance status. Not all clients were assessed for health insurance status if
billing was not involved.
Small population of persons who come to the office for footcare haven't
been assessed for health insurance status
Redwood Renville
All but correctional health
Pine
Draft June 22, 2006
11
CHB/County/City Explanation for not assessing all clients for health insurance status
WIC is contracted to the CAP Agency to provide services. Correctional
Health collaborates with Public Health for consultation and back up
Scott
coverage.
The majority of clients are assessed for insurance status with the exception
perhaps of some the Room 111 clients. We can't definitively say that we
St. Paul-Ramsey
assessed ALL clients.
Stearns
Swift Big Stone
Chippewa Lac
Qui Parle Yellow
Medicine
Wilkin
Winona
It depends upon the service.
Correctional health
MCH clients are assessed regarding their health insurance status. WIC
clients are not assessed except to ask about MA and Minnesota Care for
eligibility purposes.
Correctional Health clients are not assessed for health insurance status.
Correctional Health clients are entitled to services regardless of health
insurance status under Minnesota law.
7) The public health department assessed all clients (i.e., clients with a personal health record, including WIC
and correctional health) without health insurance for public program insurance eligibility and referred clients to
appropriate resources.
•
•
53 entities responded yes (69%)
24 entities responded no (31%)
Explanation for not assessing clients without health insurance for
CHB/County/City program eligibility and referral to appropriate resources
Beltrami
Lack of adequate staffing & providers (dental)
Carlton
Dakota
Goodhue
Correctional Health not referred (inmates)
We currently do not do assess all correctional health clients for health
insurance and we do not see WIC clients. We are looking at changing this
practice in the future. We do assess and refer all of our other clients.
We do not assess for eligibility. we refer for an eligibility assessment for
other appropriate resources
Do for all except Correctional Health
Isanti
except correctional health
Carver
Kandiyohi
Occurring in all areas consistently except Correctional Health
Lake of the Woods Not done consistently with all clients
Marshall
Some but not all.
McLeod
Minneapolis
Social Worker at Jail/Correctional Inmates
Many, but not all.
Mower
all but correctional health
Nicollet
Olmsted
Correctional health assessments were not reviewed by nurse
Have not assessed in WIC area.
Not all clients were assessed for health insurance status, but if a client
requested information on access to financial programs, a referral would be
made.
Pine
Draft June 22, 2006
12
Explanation for not assessing clients without health insurance for
CHB/County/City program eligibility and referral to appropriate resources
All clients indicating no insurance coverage are given packet regarding
Pope
MNCare and MA but eligibility assessment not done with all
Redwood Renville
St. Paul-Ramsey
Stearns
Swift Big Stone
Chippewa Lac
Qui Parle Yellow
Medicine
All but correctional health
The majority of clients are assessed and referred as appropriate. We can't
definitively say that we assessed and referred ALL eligible clients.
If a health insurance issue is identified, clients are referred to appropriate
resources to determine eligibility.
correctional health
Wadena
All except senior health screening and correctional health.
Wilkin
MCH clients are referred; WIC clients are not always referred.
Intermediate Results
1) Describe progress and/or results the public health department has made to address gaps in and barriers to
health care services.
CHB/County/City Progress made to address gaps in/barriers to health care services
Aitkin
Brown
Established senior collaborative
Worked with development of resource fair for non English speaking clients
-held monthly. CTC outreach worked with "Give kids a smile" to offer
dental care. ECHO - Emergency Community Health Outreach participation with information used.
Aggressive Collaborative formed to set-up community dental clinic fro
uninsured and underinsured to begin Spring 2007
We now have a more open relationship with the clinics. They are
beginning to make referrals to PH when appropriate for our services.
Assess all families seen in all programs for health care status, provide
application forms for MA and Assured Access, assist clients to fill out
forms, provide bi-lingual community health workers to help Latino
families complete paperwork and applications as needed, provide stamps
for mailing applications, list of low-cost medical and dental care resources
available, transportation to health care has been arranged with local
volunteer agency
The focus of our efforts this past year have been on transportation and
cultural diversity. We now have two organizations located in the county
who have contracted with the county to provide professional medical
interpreters. We have contracted wit a local non-profit to provide
transportation to medical appointments when necessary, but the overall
transportation picture can still be difficult for those members of our
community without a car, as we have very limited mass transit.
provide family planning services; Prenatal vitamin program for persons
without health insurance; NACo Prescription Drug Discount card program;
continue to provide home health care services on a sliding fee scale basis
Carlton
Birth to Three Evaluation - reaching children with delays C&TC Outreach
Anoka
Beltrami
Benton
Bloomington,
Edina & Richfield
Blue Earth
Draft June 22, 2006
13
CHB/County/City Progress made to address gaps in/barriers to health care services
Low-cost/free dental services are now available to children and pregnant
women at the CAP agency. Three new Adult Foster Homes were opened to
serve those disabled with mental illness and are unable to live
independently. Residents able to receive a health assessment obtain
information and education and be referred to appropriate community
Carver
resources at the River Valley Nursing Center.
A federal grant was awarded to address the lack of Family Planning clinics
in a three county area. In 2005 contracts were secured between three
county public health agencies, four medical clinics, one Family Center and
a Community Action Family Planning program to expand family planning
services to 5 additional locations. Clinics began in the fall of 2005.
Additional work is being done in the areas of risk assessment of women
utilizing the clinics, preconception care, and evaluation of outcomes.
Urgent Care/ Critical access hospital: A needs assessment and feasibility
study were completed, a Task Force was formed, a legislative initiative
was sought for an exemption of the hospital moratorium, and work began
with the federal congressional delegation to change guidelines for
designation as a critical access hospital. Care Coordination for MSHO
started in October 2005, identifying needs and coordinating services for
Cass
enrollees. This includes access to health care.
Better integration of PHN's and Social workers to identify and refer adult
populations to appropriate services
Chisago
Providing school & correctional health services along with home care &
Clearwater
hospice
Cook
Dakota
County Based Purchasing
Personnel with in the agency serve on boards as the Elizabeth House,
Circles of Support, Long Term Task Force and Family Service Network.
Each of the coalitions achieves so much in any given year that it is not
possible to quantify it. Sometimes new services have been secured and
some efforts take long term support of the agency to maybe see successes.
I know many of the staff work very hard and have numerous times been
the driving force for a family or individual getting on MA or being seen by
a physician.
Basic Life Needs: This is an ongoing service we provide. We provide inhome care, nutrition counseling, referral & resource services. Dental:
Collaborated on a community dental clinic began in 2005. Arthritis
services: identified lack of providers for Arthritis Foundation programs.
PROJECT 1 Community stakeholder group to address health care access
issues/supports was convened. Outcomes include: 1. Increased awareness
of low cost health resources based on increased hits on web site and
increased phone inquiries and 2. Low-Cost Health Resources was posted
on website May, 2005 and in last 6 months of 2005 averaged 297 visits per
month. Inquiries to the department regarding low cost health care increased
by 29% from 2004 to 2005; and PROJECT 2 Provided technical assistance
to 3 projects (Burnsville Schools with Park Nicollet, expansion request for
St. Mary s Clinic, and expansion of Portico coverage/outreach in Dakota
County) resulting in increased communication between county staff with
outreach staff in non-profits.
Douglas
Collaborative efforts are being made to address Oral Health Care.
Cottonwood
Jackson
Crow Wing
Draft June 22, 2006
14
CHB/County/City Progress made to address gaps in/barriers to health care services
Influential in promoting Assisted Living facilities in the community, lead
agency for MSHO, Receive free blood test kits for neonatal screens on
Fillmore
Amish babies,
Hired a full-time staff person to assume the role of Community Resource
Freeborn
Management Team leader (see description in question #4 above).
1. Have encouraged development of and contract with Adult Daycares,
Home Care Agencies new to Goodhue County and new Assisted Living
Facilities. 2. Initiated a group of professionals to assess the difficulties
community members have with obtaining prescription medications.
Community educational meetings were held county wide and included
information on Medicare D. 3. We contacted and requested a week of the
UCare Toothcare Van's time in Goodhue County. They served 39 patients
during the week with both preventive and more extensive care. 4. Our
CRMT who is a social worker has been doing health screenings since June
2005 of our South Country Health Alliance members. Though previously
done by insurance companies, this is the first time MA recipients have
Goodhue
received this benefit of preventive health care.
Contract w/ Community clinics and provide assistance accessing MA
Hennepin
covered services
Houston
Dental access, increase in long-term care assessments
Hubbard
Assisted with a resource directory and getting it into the community;
As part of the Early Childhood Coalition we were able to provide 24 kids
with comprehensive eye exams or glasses that did not have insurance.
Worked with one local Dentist for Give a Kid a Smile day. Saw 12 kids
Isanti
Itasca
Kanabec
Kandiyohi
Koochiching
Provide flu shots to community cafe participants Office clinics till 6 pm.
We have a new mobile dental clinic that comes to Mora twice a month for
both adults and pediatric clients that are underserved.
MNCare Outreach, Dental Van through health plan, Involvement in
hospital dental proposal, worked with other health care providers related to
interpreting issues, referrals to community resources
Family planning clinic setup, home care re-established, family
collaborative formed, after hours clinics scheduled
Lake
Liaison with SuperiorHealth Medical Group and Bay Area Health Clinic
Conducted focus groups to address issue of health care access as well as
the high cost of health care services. Expect to work more on barriers to
health care services in 2006. In 2005 the local health department addressed
the gap related to seniors’ noncompliance with medications due to cost
through outreach and education of Medicare's Part D benefit. Staff
attended education and offer assistance to Seniors in the Medicare Part D
Lake of the Woods enrollment process.
Area Agency on Aging has added transportation services for Le Sueur
LeSueur
county residents.
Lincoln Lyon
increase the participation rate of Medical Assistance and MinnesotaCare
Murray Pipestone enrolled children aged 0 to 21 in the Child and Teen Check-up program
Mahnomen
Needs Assessment
Provide C&TC's, vaccination clinic's, Health Promotion clinic's, in
Marshall
outlaying area's of the County.
McLeod
Draft June 22, 2006
Much of our information is bilingual and some of our staff can speak
15
CHB/County/City Progress made to address gaps in/barriers to health care services
Spanish
Meeker
Mille Lacs
Minneapolis
Morrison
Mower
Nicollet
Olmsted
Otter Tail
Pennington
Pine
Polk
Pope
Red Lake
Redwood Renville
Rice
Draft June 22, 2006
County based purchasing (Prime West) addresses issues related to access
by providing incentives for members and care coordination/case
management of members with complex needs; Meeker County Public
Transit and public health collaborate to provide bus tokens for
transportation to health care appointments; pregnancy tests are provided to
low income women to verify pregnancy and thus allowing access to early
prenatal care though medical assistance
Provide MA forms to individuals. Assist individuals to receive services
until there is another resource, such as obtain medication, equipment and
health care appointments.
Support for access programs - New Family Center for limited English,
support for 489-CARE, School Based Clinics.
Dental services - dental van
Back-to-school immunization clinic during the morning of the first day of
school.
Public Health did not have anything to do with this but there is a new
dental provider in St. Peter
Community Care Staffing Network - work on staffing for home care.
EHDI - refer to grant report. Senior Summit - prioritized issues
Continually work on improving dental services and established a portable
dental clinic in the New York Mills community. Also a Public
Transportation Program will be starting in July of 2006
Referrals to Social Services
Have continued to screen for new home care providers that are Medicare
certified. If no home care provider is available to service a client in a
particular geographic location, services are revised in order to meet that
client's needs. Transportation for non-medical appointments continues to
be an issue, but occasionally has been resolved with the use of Companion
Care services. Low income continues to be a problem in Pine County;
many clients are referred to our Income Maintenance unit to be screened
for MA eligibility.
Family Planning Clinics: have contracted with Altru Clinic for FNP
services for paps, exams, STD testing. Participate in NE North Dakota and
NW Minnesota Dental Access Coalition, planning for opening a dental
clinic in Grand Forks or East Grand Forks. Foot Care Clinics held in 3
communities. Immunization clinics held in 2 communities. Car Seat
training offered in 3 communities.
Public Health worked with the Pope County Early Childhood Initiative to
personally meet with local dentists to encourage them to accept more
medical assistance clients unfortunately dentists were not willing to accept
more MA clients.
Referrals to Social Services
Distribute MNCare forms
The department provides immunization services to persons without a
"medical home"; persons without insurance are referred when appropriate,
for services and insurance applications; the department routinely makes
educational materials available in the languages spoken by our clients.
16
CHB/County/City Progress made to address gaps in/barriers to health care services
Children's Dental Care Clinic Collaboration and planning to provide dental
care services to the uninsured, underinsured those with children and
pregnant women with MA in Scott County. River Valley Nursing Center
collaboration planning and opening of the nursing center to provide
nursing assessment, interventions, referrals, and follow up to individuals in
need of services that are uninsured or underinsured. Through collaborating
efforts with IEIC members, Public Health provided education to physicians
and clinics about developmental screening tools and early intervention
Scott
resources for children with developmental disabilities.
We seek United Way funding to help support our Kids Clinic. The money
is used for general support but it helps fund lead testing for children who
are on sliding fee. The lead test has a charge over and above the sliding fee
Sherburne
and United Way dollars help fund those tests.
Sibley County is partnered with South Country Health Alliance, a countybased purchasing program that provides medical assistance to those who
qualify, through this collaboration we are better able to serve this
Sibley
population.
The Northeast Regional C&TC Partnership, including Health Plans, work
St. Louis
collaboratively to improve access to health care.
Efforts include: -Fund community clinics serving uninsured. -Provide
uninsured care through lease agreement with Region's Hospital. -Work
with health plans regarding uninsured care. -Participate in "Cover All
Kids" initiative. -Conduct outreach for MN Care at clinic (555 Cedar). Continued relationship building and joint projects with health plans
through Child & Teen Checkups. Participation in C&TC clinics is
St. Paul-Ramsey
increasing.
1. Through the Senior Health Clinics, seniors are assisted with the
connections to appropriate resources for their needs. 2. The Release
Advance Planning (RAP) Team for the County jail assists inmates in
planning for life upon release from jail. 3. C&TC staff worked with a
mobile dental provider to promote that service as an additional dental
provider for the community. 4. To address the increasing need for
psychiatric services in the jail, funds were budgeted for 2006 for
Stearns
psychiatric services to be brought into the jail.
Community organizing in the areas of cultural competence. Collaboration
and Coalition Building in the area of chemical use (esp. tobacco) - SHOC,
Steele Dodge
Smoke Free Coalition, Meth. Task Force, Drug Control Committee.
Swift Big Stone
Chippewa Lac
Qui Parle Yellow
Collaboration with RICE Hospital on a dental grant to bring dental services
Medicine
to our community. Promotion of "Give a Kid a Smile".
Expansion in transportation access, in-home respite and caregiver support,
fiscal intermediary access for those CDCS programs, expanded on noncounty case management, increased access to assisted living facilities, rural
Todd
expansion for delivery of Meals on Wheels.
-now have MNDOT public access bus for transportation -now have two
Wadena
dental clinics for MA clients
Wabasha County is a member of the 9 county South Country Health
Alliance. Because of this we have been able to make a major inroad on the
Wasbasha
number of uninsured in our county. SCHA reimburses us to outreach low
Draft June 22, 2006
17
CHB/County/City Progress made to address gaps in/barriers to health care services
income. Also has helped bring a dental van into our county to serve the
MA population as well as helped develop a transportation system for the
MA population
regular meetings with local providers, participation in community forums
Waseca
and workgroups
Quarterly Healthcare Network meetings strengthened our relationships
with clinics and educated them about needs and services in the community.
Support depression screenings in school for early identification of
individuals needing help. Coordinate the county-wide school-based
Washington
chemical health service system.
Increased outreach and health education to Latino population home via
Watonwan
visits.
The public health agency staff worked with an area provider to assess the
need and determine the feasibility of building an assisted living memory
care facility in Breckenridge. At the present time the facility is being built
Wilkin
with completion expected in June 2006.
Winona County CHS Board annual reviews the public health issues
regarding the Minnesota Legislative session. In 2005, the Board
specifically supported the need to change the Emergency Preparedness Act
and the barriers to isolation and quarantine were address if needed to
protect the masses during natural or man-made disasters. This is an
intermediate goal, as we have not had to put the changes to the test in a real
situation.
Winona
Wright
Collaborated with local hospital for health fair at Latino Market.
2) Give an example of actions the public health department took to improve accessibility of health services.
CHB/County/City Actions to improve accessibility of health services
Aitkin
Offered CTC check ups during sports physicals
Developed a direct observed therapy case management team - coordinated
efforts for DOT clients; Hurricane Katrina response team; offer
immunization clinics.
Anoka
By incorporating community health within human services, have been able
Becker
to successfully integrate services for the community.
Beltrami
Benton
Bloomington,
Edina & Richfield
Blue Earth
Draft June 22, 2006
Through C&CT outreach arranged transportation for multiple client visits
PH has been making joint clinic visits with our neighboring counties to
improve the communication with the clinics and PH. We have also been
doing joint education to clients regarding the needs and barriers of our
clients both English speaking and non English speaking.
Developed and implemented senior PHN clinics in Bloomington senior
center and low-income senior high-rises
Assisting Open Door Health Center with obtaining VFC for their
immunization program. We have been working with local interpreters to
get them contracted with UCare to improve the access to interpreters in this
community. We have contracted with VINE to provide transportation to
clients to medical appointments, which would not otherwise be covered.
18
Brown
Carlton
Carver
Cass
Clearwater
Cook
Cottonwood
Jackson
Crow Wing
Dakota
Douglas
Fillmore
Freeborn
Goodhue
Hennepin
Houston
Draft June 22, 2006
NACo Prescription Drug Discount card program & Approached Watonwan
county Public Health to extend Family Planning program to that county
and the Hispanic population that is uninsured
Began to implement Health Care Access Office
PHN staff was added to immunization clinics specifically to assist clients
in finding needed resources.
A mammography unit was obtained through grant funding to maintain
services otherwise not found within our county. The agency applied for a
federal grant to obtain funding for family planning clinics.
Providing Certified Diabetic Education services thru Public Health
Expanding Choice In Home and Healthcare Options (ECHHO) Multicounty project. Public Health Role - Group Activities: gathering partners,
outreach, training, writing business plan, creating fiscal agent. Goal:
Expand accessible services for seniors, senior mini clinics, Project Life
Saver
Continual outreach to local physicians, schools and other community group
to speak of prevention the need for public health and others health
providers to work together to address accessibility. We do promote Public
Health Nurse Clinics at our offices to give more options to individuals that
do not want LPH in their homes.
Basic Life Needs: Connected clients with resources, provided in-home care
services, distributed WIC vouchers to assure nutritional needs are met.
Arthritis: worked with providers to implement Arthritis Foundation
programs. Dental: worked with Central Lakes College Dental Hygienist
School.
- Provided PHN Clinics for elders in senior apartments, focusing on
referral to health care system for follow-up; - Started contracts with Health
Plans for MN Senior Health Options with emphasis on coordinating acute,
chronic and long-term care. - Coordinated with Portico Healthnet to
connect uninsured/underinsured persons with health care programs. Provided funding to Neighborhood Health Care Network to provide
information and referral to low cost health care providers for Dakota
County residents. - Helped promote Give Kids a Smile campaign to
provide preventive dental services - Dakota County Public Health has been
a partner in the Oral Health Special Project, a collaborative of dental
professionals and public health staff who are seeking to improve access to
dental services for children on Medical Assistance.
Case Management - a process is in place to assure annual medical care for
all annual medical care for all clients with the case manager accompanying
elderly clients to clinic appointment as needed.
administer immunizations and blood tests to the Amish in their homes,
conduct monthly BP and yearly flu clinics in each town in Fillmore County
The CRMT refers appropriate enrollees to the disease management
programs offered by SCHA(DM, depression and asthma). Distributes
prescription discount cards offered by NACO.
Goodhue County Public Health Service has worked with the new Faith in
Action group to realign the dispatching of volunteer drivers to better meet
the needs of county residents.
We are integrating aging and disabilities services
Dental clinics offered on Saturdays
19
Hubbard
Itasca
Kanabec
Kandiyohi
Koochiching
Lake
Assisted with the opening of a dental clinic for public program enrollees
Change time of immunization and WIC to be @ same time - evening hours
Working with clients on SCHA to get there medications and into the
programs that they have available to them.
Staff members spends significant time identifying eligible patients and
providing outreach to get them appointments.
After hours scheduled for public health clinics, 24 hour home care
Senior Mini Clinics
Lake of the Woods Assisting seniors in enrollment process for Medicare Part D
Using Spanish speaking interpreter for WIC clinics and linking to other
LeSueur
services.
* Assisted clients with making appointments finding transportation as part
of C&TC Outreach * Convene a meeting with clinic employers, etc.
regarding health needs and services pertaining to tuberculosis * Contacted
Lincoln Lyon
all pregnant women participating in the Integrated Prenatal Project in an
Murray Pipestone effort to link them to resources and services according to need
Mahnomen
Arranged transportation
Provide C&TC's, vaccination clinic's, Health Promotion clinic's, in
outlaying area's of the County.
Marshall
McLeod
We contract with an individual for Hispanic Outreach
Bus tokens for Meeker County Transit, gas vouchers for family health
Meeker
clients to assist low income families to access health care
Encourage pregnant women to complete MA forms. Obtain sample
Mille Lacs
medication. Seek sources that may have equipment in storage.
Provide immunization clinics on site at each school district. Established a
back-to-school immunization clinic at the public health office for families
Mower
needing to avoid school exclusion.
Nicollet
Olmsted
Otter Tail
Pennington
Pine
Polk
Pope
Red Lake
Redwood Renville
Draft June 22, 2006
Hire trained interpreters, forms in appropriate languages and use of ECHO
Initiated a Home Care Access Task Force to identify strategies to improve
health care access for the underserved.
Donated portable dental clinic equipment to a state operated dental clinic
Evening & weekend immunization clinics
Have referred clients with dental needs to clinics that will accept medical
assistance; try to complete LTCC screenings within 10 working days of
referral, complete PCA assessments in same manner; refer to other
agencies or programs if necessary; make health promotion visits to
determine service needs; make joint home visits with social service
personnel if cases require the involvement of multiple disciplines.
Evening Immunization Clinics. Family Planning walk in times, Mondays
and Thursdays, 2:00-4:30 p.m. and Tuesdays at 7:00 a.m. to 9:00 a.m.
Working with 4 Health Plans, Blues, U-Care, MHP, and Medica on
services for PMAP/MSHO clients. Working with 4 health plans on
improving transportation for clients. Dental coalition, working on dental
clinic plans.
Relative to Dental Health the Public Health Dept researched Dental clinics
accepting new MA clients and the process for scheduling then worked with
client to get them scheduled.
Evening & weekend immunization clinics
Distribute MNCare forms, worked with Headstart on dental access
20
Rice
Scott
Sherburne
Sibley
St. Louis
St. Paul-Ramsey
Stearns
Steele Dodge
Stevens Grant
Traverse
Swift Big Stone
Chippewa Lac
Qui Parle Yellow
Medicine
Todd
Wadena
Wasbasha
Draft June 22, 2006
Rice County joined the National Association of Counties in offering a
prescription discount card for all Rice County residents.
PH collaborative with other agencies to open Nursing Center that provides
free bilingual nursing services, support, guidance, education and referrals
to affordable healthcare, social, dental, and community services for the
uninsured and underinsured vulnerable individuals in our communities.
Bilingual C&TC outreach worker Spanish/English provides more effective
and personal outreach than through an interpreter.
The Public Health Department worked with a provider to bring a mobile
dental clinic to the county
Through specific grants Sibley County Public Health purchased gas
vouchers and local bus tokens to assist in transportation needs. Provide onsite blood pressure clinics at Senior Dining Sites. Provide monthly
immunization clinics, during our WIC clinic. We also contracted with a
dental hygienist to provide prophylactic and preventive dental care to
children during our WIC clinic.
Funded C&TC Outreach in seven primary care clinics in St. Louis County
which resulted in extended clinic hours.
-We provide assistance to clients in making clinic appointments and
arranging for interpretation and transportation as needed. -In an attempt to
decrease the failure rate for clinical appointments in the TB and Refugee
Screening Programs, we directly arrange transportation for clients to and
from the clinic.
1. The majority of the Senior Clinics are held in Senior Centers. 2. Jail
health is provided right in the jail by a doctor coming into the jail facility
itself.
Dental Services- Hygienist at Dodge Co. Office during WIC, participated
in Give Kids a Smile Project. Both Counties are part of County Based
Purchasing which requested a health screening for all enrollees and utilizes
Community Resource Management Team (RN and Social Worker) to
follow-up with each enrollee for care management-early intervention and
prevention.
BEGAN WORK ON FAMILY PLANNING CLINICS
Creating a Jail/School workgroup to create some standards of care for
correctional health and in the schools we serve.
Extend WIC hours later. Added one Public Health Nurse Clinic.
Implemented a Rural Health Outreach Family Planning Clinic. Home visits
to Amish to vaccinate.
-worked with Dr. Rose, DDM to assess need and sites and political
acceptance by local dentists of dental clinics for MA only clients.
Wabasha County is a member of the 9 county South Country Health
Alliance. Because of this we have been able to make a major inroad on the
number of uninsured in our county. SCHA reimburses us to outreach low
income. Also has helped bring a dental van into our county to serve the
MA population as well as helped develop a transportation system for the
MA population
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Waseca
Washington
Watonwan
Wilkin
Winona
Wright
Lack of dental providers for people on public assistance. Worked with
UCare and the UCare dental van visited Waseca Co. 4 times in 2005.
Increased interpreter resources. Created and distributed Aging Resource
Guides and Family Health Resource Guides.
All public health clinic participants without insurance are referred to our
Income Maintenance Unit to apply for MHCP. Also referred to the Open
Door clinic for services.
Is working with a local chemical prevention coalition to improve early
identification of problems and access to chemical health treatment for
adolescents.
On November 21, 2005 the CHS Department administratively took on the
County Health Insurance MSHO contracts with Secure Blue and U-Care as
lead agency, not only for the lead in case screening and management, but
for fiscal responsibility. This decision was to provide the safety net for the
vulnerable elderly in the statewide roll over of 428 clients and their
provider service agreements effective January 1, 2006. The County has
encouraged all vendors to become self sufficient in billing the health plans,
however, one time service needs or small local vendors remain supported
by the County fiscal reimbursement system though CHS.
Wellness On Wheels (WOW) van stops in many communities within the
county.
3a) How many WIC participants were assessed for health insurance status at the initial certification visit?
•
23 entities responded with numbers (30%)
Minimum
308
Maximum
10187
Average
2078
Std.
Deviation
2439
3b) Of those assessed, how many WIC participants did not have any health insurance at the initial certification
visit?
•
3 entities responded with numbers (4%)
Minimum
1
Maximum
268
Average
97
Std.
Deviation
148
3c) For answers 3a and 3b, is each participant only counted once? (This question was not answered correctly,
so the data is not provided.)
4a) How many other clients (not in WIC) were assessed for health insurance status?
•
21 entities responded with numbers (27%)
Minimum
39
Draft June 22, 2006
Maximum
23963
Average
2492
Std.
Deviation
5161
22
4b) Of those assessed, how many other clients (not in WIC) did not have any health insurance?
•
7 entities responded with numbers (9%)
Minimum
0
Maximum
90
Average
37
Std.
Deviation
36
4c) For answers 4a and 4b, are these unduplicated numbers? (This question was not answered correctly, so
the data is not provided.)
Draft June 22, 2006
23