Annual Report FY 2008/2009 Herbert K. Abrams Public Health Center 3950 S. Country Club Road Tucson, Arizona 85714 T ABLE OF C ONTENTS Board Members and Administration The Mission Director’s Message Budget Expenditures Budget Revenues The Organization Functional Areas ♦ Director’s Office ♦ Disease Prevention ♦ Pima Animal Care Center ♦ Health Promotion and Education ♦ Chief Medical Officer ♦ Public Health Nursing ♦ Administrative Services ♦ Emergency Management and Homeland Security Prepared by: Strategic Health Planning and Public Education Program Pima County Board of Supervisors Honorable Ann Day District 1 Honorable Ramón Valadez District 2 Honorable Sharon Bronson District 3 Honorable Ray Carroll District 4 Honorable Richard Elías, Chair District 5 County Administration C. H. Huckelberry, County Administrator Dennis Douglas, Deputy County Administrator Medical and Health Services Pima County Board of Health Paul Horwitz, M.D., President Lidia Allen, Vice President Kwang Chun An Bradley Brumm, DDS Richard Elías, Ex-Officio Vincent A. Fulginiti, MD Mary Lou Gonzales Hector Morales Pima County Health Department Chuck Stopani Sherry Daniels, MS, MPH, RN, Director Carolyn Trowbridge, R.N. Michelle McDonald, M.D., Chief Medical Officer Jeff Guthrie (acting), Manager, Emergency Management & Homeland Security Kim Janes, Manager, Pima Animal Care Center Isela Luna, Manager, Public Health Nursing Karen Martin, Manager, Health Promotion and Education Brad McKinney, Manager, Communicable Disease Prevention Rebecca Melland, Manager, Administrative Services T HE M ISSION Our Vision...to help the residents of Pima County achieve and maintain an optimal level of wellness. Our Mission...to be a leader in protecting health, preventing disease and promoting community well‐being. C ULTURAL D IVERSITY Pima County Health Department and its members are committed to embracing and promoting diversity throughout our programs. Our rich diversity of racial and ethnic heritage, gender, sexual orientation and other life experiences enhances our work environment, collaboration with our community partners, care for our clients, and our public health presence throughout Pima County. D IRECTOR ’ S M ESSAGE During Fiscal Year 2008/2009, the Department worked to prevent disease, promote health and provide needed public health services. We were able to expand disease prevention services through a $60,000 grant from the Tohono O’odam Nation. In October 2008, the Pima Animal Care Center broke ground for a shelter expansion of the adoption areas for both cats and dogs, and the creation of visitation yards for prospective owners to get to know a new pet. In the Spring of 2009, staff responded to the arrival of the novel influenza A virus, also known as H1N1 or Swine Flu. Vital information was provided to the medical community, and the Department call center was opened to respond to questions from the community. The Department launched a community‐wide educational campaign to eliminate mosquito breeding sites; created a dedicated phone number to report standing water and green pools; and conducted investigations and treatment on a timely basis. At the request of the Board of Health, a report on grocery store inspection ratings was presented and letters were sent to the operators encouraging compliance with sanitary codes. The Department continues to meet the public health needs of our residents by providing services that bring opportunity for wellness. Within this annual report, you will read about the accomplishments of the dedicated and professional staff who serve our community. Looking forward, the Department will assure early response to disease outbreaks and continue to work with federal, state and local partners to bring necessary resources to meet emerging health needs. Most importantly, we will inform residents of crucial health risks and how to protect families and individuals from such risks. Sherry Daniels, MS, MPH, RN Director, Pima County Health Department June 2010 Budget Expenditures Pima County Health Department Expenses FY 2008/2009 Administrative Services Tobacco Prevention and Education Community Nutrition Programs Public Health Nursing Administrative Services Consumer Health and Food Safety Director's Office Community Nutrition Programs Consumer Health and Food Safety Director's Office Disease Prevention Emergency Mgt/Homeland Security Family Planning Disease Prevention Pima Animal Care Center One Percent forYouth Pima Animal Care Center One Percent forYouth Mobile Services Mobile Services Family Planning Emergency Mgt/Homeland Security Public Health Nursing Tobacco Prevention and Education T O TA L E X P E N D I T U R E S $ 2 7 , 2 8 8 , 0 9 3 Disease Prevention 19% Pima Animal Care Center 19% Public Health Nursing 18% Community Nutrition Programs 15% Tobacco Prevention and Education 9% Consumer Health and Food Safety 7% Family Planning 6% The Following Programs Represent 3% or Less of Budget Expenditures Director's Office Mobile Services Emergency Mgt/Homeland Security One Percent for Youth Administrative Services Budget Revenues Pim a County Health Departm ent Revenues FY 2008/2009 Administrative Services Community Nutrition Programs Consumer Health and Food Safety Other Revenue Director's Office Disease Prevention Emergency Mgt/Homeland Security Administrative Services Community Nutrition Programs Consumer Health and Food Safety Director's Office Disease Prevention Emergency Mgt/Homeland Security Family Planning Mobile Services Family Planning One Percent forYouth Mobile Services One Percent for Youth Tobacco Prevention and Education Pima Animal Care Center Public Health Nursing Pima Animal Care Center Public Health Nursing Tobacco Prevention and Education Other Revenue T OTA L R e v e n u e s $ 2 7 , 2 8 8 , 0 9 3 Other Revenue 37% Tobacco Prevention and Education 9% Disease Prevention 10% Consumer Health and Food Safety 4% Community Nutrition Programs 11% Public Health Nursing 5% Family Planning 4% Pima Animal Care Center 15% Administrative Services 4% The Following Programs Represent Less Than 3% of Budget Revenues Director's Office Mobile Services Emergency Mgt/Homeland Security One Percent for Youth The Organization Staffing by Functional Area Director’s Office 11.3 FTEs Administrative Health Services 24.3 FTEs Disease Prevention 80.0 FTEs Emergency Management and Homeland Security Health Promotion and Education 9.0 FTEs 111.1 FTEs Pima Animal Care Center 78.5 FTEs Public Health Nursing 66.6 FTEs Director’s Office Director ♦ ♦ ♦ ♦ ♦ Assures Department compliance with all Pima County policies, procedures and codes. Addresses all Board of Supervisor inquiries and requests regarding public health issues. Responsible for 380.8 FTEs and an annual budget of $27,288,093. Oversees Grants providing $10,143,181 in revenue. Responsible for six divisions that provide multiple public health programs in Pima County. Programs ~ Director ~ Strategic Health Planning and Public Education ~ Website Strategic Health Planning Researches and develops educational material for public distribution, promoting healthy life-styles through evidence-based health education and assists with response to community health risks. Public Education/Public Information Officer (PIO) The Community Relations Manager represents Pima County Health Department through effective, accurate and timely communication with local media partners. Operates as the PIO for the Office of Emergency Management and Homeland Security during times of disaster or community threat. Program Accomplishments ♦ During the early development of the novel influenza A (H1N1 initially referred to as Swine Flu) threat to our community, the PIO coordinated communications for healthcare providers and the residents with unfolding status and information provided by the Centers for Disease and Prevention Control. ♦ Partnered with the community middle schools and after school programs to provide educational presentations for students regarding hygiene and germ transmission. ♦ Represented Pima County Health Department at more than 25 health fairs, community events, and presentations on public health issues. Website The goal of the website is to present visitors with a user-friendly tool providing pertinent and current information regarding local and national public health issues. Program Accomplishments During this year the website enhancements facilitated significant improvements in our efforts to provide the community with public health information. The redesigned website’s features included: ♦ Text re-sizing ♦ Embedded registration forms ♦ Printer and mobile friendly page formatting ♦ Social media networks ♦ Website search within the main menu ♦ Folksonomy (ability to bookmark or email a page) Upgraded features have increased time spent on the website and significantly decreased the bounce rate. Improved Search Engine Optimization efforts have increased page ranking. Disease Prevention Programs ~ Epidemiology ~ Vaccine Preventable Diseases ~ Family Planning and Women’s Health ~ HIV and STD Program ~ Tuberculosis Clinical Program ~ Public Health Preparedness Epidemiology Epidemiologists carefully monitor patterns to detect increases in disease or potential epidemics. Through surveillance, investigation, intervention and education, the program strives to reduce illness and death from infectious diseases and public health emergencies. The Epidemiology team designs and develops the community health status report identifying communicable diseases of public health significance. This information provides statistical data to reduce future incidents of communicable diseases in Pima County. Program Accomplishments ♦ Neisseria meningitis case investigation was conducted involving a six month old baby. Approximately sixty babies enrolled in a high school daycare program for teen parents were exposed to case. Approximately 138 teen parents and pregnant teens had potential exposure. Prophylaxis medication was offered to the babies, students and staff exposed to infection. There were no additional cases reported to the Health Department. ♦ The Epidemiology team responded to outbreak of novel influenza A (H1N1 or Swine Flu) in the final weeks of April 2009. Epidemiologists and Communicable Disease Investigators investigated reports of case-patients positive for influenza A; coordinated specimen collection and transport; and communicated with providers and infection control practitioners, school nurses and the general public as part of a nationwide investigation. No cases were confirmed in Pima County in April 2009. Community Partnerships In 2009 the Health Department increased the number of influenza sentinel sites through the acquisition of a $60,000 grant from Grant‐in‐Aid Indian Gaming Revenue Funding Agreement from the Tohono O’odham Nation. All ten Pima County sentinel sites received an equal amount to assist with their operations including increasing staff and or supplies to conduct surveillance operations. Vaccine Preventable Diseases ♦ In September of 2008 the vaccination rules for children changed and middle school aged children are now required to have menigococal vaccine and be vaccinated for tetanus, diphtheria and pertussis before attending school. ♦ Staff conducted over 800 record assessments of local schools and childcare centers for state vaccination compliance. ♦ A total of 66 facility audits were performed at childcare centers and public schools. Swine Flu Emerges In the month of April, the ongoing outbreak of novel influenza A (H1N1) required activation of the rapid response team, as the event was classified a public health emergency. Staff participated in investigative health intelligence and disease surveillance. Perinatal Hepatitis B Program strives to prevent the spread of hepatitis B virus from mother to newborn. To help educate new mothers to the risks of hepatitis viruses, 11,800 information packets were prepared and distributed to local hospitals. This year, a total of 62 pregnant women and 174 infants were identified as high risk and received vaccinations and educational materials. Disease Prevention Family Planning and Women’s Health Program serves families, women and teens. The Family Planning Program Provides individuals with information and the means to exercise personal choice in determining the number and spacing of their children. The program is funded in part by Pima County tax dollars and over $823,000 in Federal Title X funds. All services were provided on a sliding fee basis and no client is refused service based on inability to pay. National data shows that each public dollar spent to provide family planning services saves an average of $3 in Medicaid costs for pregnancy related and newborn care. In Arizona, the average birth is approximately $5,000 and 52 percent of all births are paid for by state Medicaid dollars. A full year of Programs family planning services costs less than $250. ~ Epidemiology ~ Vaccine Preventable Diseases ~ Family Planning and Women’s Health ~ HIV and STD Program ~ Tuberculosis Clinical Program ~ Public Health Preparedness Program Accomplishments ♦ Family Planning Program served 7,031 unduplicated clients and provided 13,248 direct services related to family planning, sexually transmitted diseases, breast/cervical cancer screening and pharmaceutical distribution to clients who are un-insured or underinsured. Well Woman HealthCheck Provides diagnostic services to uninsured and underinsured women primarily over the age of 50 within Pima County. The program goal is to increase the awareness of female related cancers and reduce the number afflicted by providing breast and cervical screening and education. Women with symptoms of these cancers, and women who have had a tubal ligation can receive services regardless of age. Services are provided through a network of local providers and Health Department clinicians. Program Accomplishments ♦ The Well Woman program provided more than 1,700 medically underserved women with breast and/or cervical cancer screening. Project CONTACT Community Outreach Network Teaching Adolescents Contraceptive Techniques (CONTACT) is a community based program that conducts outreach to youth that are homeless or at risk of becoming homeless. The program is designed to help youth at high risk of pregnancy or sexually transmitted disease infections obtain needed reproductive health services. Program Accomplishments ♦ Project CONTACT served 518 unduplicated students at three high schools within Sunnyside Unified School District. Based on student surveys, most teens would not seek these services elsewhere, hence the importance of having on-site services for this high risk population. Disease Prevention Programs ~ Epidemiology ~ Vaccine Preventable Diseases ~ Family Planning and Women’s Health ~ HIV and STD Program ~ Tuberculosis Clinical Program ~ Public Health Preparedness HIV and STD Program Strives to prevent infection and minimize the impact of sexually transmitted diseases (STDs), including HIV, through comprehensive STD infection control, prevention, education, and treatment services for Pima County residents. Program Accomplishments ♦ The program provided 6,618 clinic visits including individuals who returned for follow-up treatment. ♦ Of those screened, 4,196 infections were diagnosed and treated. ♦ Among those diagnosed and treated were: ♦ 478 cases of Chlamydia ♦ 112 cases of Gonorrhea ♦ 66 cases of Herpes ♦ 86 cases of Syphilis In 2008/2009, the HIV and STD Program experienced a reduction in the number of cases of Gonorrhea, Herpes and Syphilis. Work continues with key community stakeholders to educate Pima County residents on safer sex practices and condom use. Successful, focused outreach that reduces incident of infection and promotes earlier testing illustrates the program’s commitment to build the community’s awareness of disease transmission and actions to reduce the spread. To further promote the mission of the program, the HIV and STD Program began increasing the use of social networks (Twitter, Facebook and MySpace). The resourcefulness of social networking proved to be successful and generated an increase of testing visits to the clinic by clients seeking to know their status prior to an HIV/STD infection. Program Accomplishments ♦ ♦ ♦ The HIV and STD Program performed 3,955 rapid HIV tests for individuals within Pima County. Of those tested, over 33 percent were considered at high risk for HIV infection because of their sexual and/or drug-using behaviors. 23 new cases of HIV were identified. Tuberculosis (TB) Clinical Program Conducts surveillance and manages persons with latent TB infection, identifies cases of active TB, and ensures completion of individual therapy. The program performs ongoing community education and training for vulnerable populations within our community. Program Accomplishments ♦ Twenty-six (26) cases completed treatment this year. Many were medically and psychologically challenged with illnesses other than TB. ♦ Two outreach workers provided over 2,800 home visits for direct observation therapy which has been shown to greatly increase the success rate of TB treatment completion. ♦ The program provided 4,261 skin tests: ♦ 1,335 employment clearance ♦ 1,967 homeless clients needing clearance for shelters ♦ 232 school attendance ♦ 93 contacts of cases needing evaluation ♦ 634 refugees needing medical clearance for residency Disease Prevention Programs ~ Epidemiology ~ Vaccine Preventable Diseases ~ Family Planning and Women’s Health ~ HIV and STD Program Public Health Preparedness Program Provides efficient and immediate incident management strategies for any nature of emergency or disaster involving public health consequences. Program Goals ♦ Improve public health workforce capacity through training and preparedness exercises. ♦ ♦ ~ Tuberculosis Clinical Program ~ Public Health Preparedness ♦ Educate community through preparedness education materials, presentations, and public announcements. Provide effective communication and management procedures for all public health response activities by implementing the National Incident Management System and Incident Command System. Ensure all preparedness and response plans are fully vetted and in compliance with local, state and federal response agencies. Program Accomplishments Two Full Scale Exercises ♦ On November 5, 2008, the program hosted a mass fatalities workshop and table-top exercise. The scenario was based on a Pandemic Influenza outbreak that was occurring in the United States with a high mortality rate. The table-top exercise was developed to provide participants of various agencies, faith-based organizations an opportunity to evaluate and discuss current religious and cultural beliefs, response concepts, plans, and capabilities to a mass fatalities event. ♦ February 2 through February 6, 2009, the program hosted a POD drill, exercising the dispensing of influenza vaccine at the Tucson International Airport. The Tucson International Airport Influenza Vaccination Drill was a full scale drill exercising the Pima County Health Department Strategic National Stockpile Plan and Mass Clinic/Point of Dispensing Standard Operating Procedure. Five Public Health Preparedness Exercises/Drills ♦ Full scale exercise testing the mobilization of a medical needs shelter supported by Medical Reserve Corp and Pima County Citizens Corp. Influenza Pima County Health Department had an opportunity to put into operation its Strategic National Stockpile Plan and Receipt, Store, Staging Warehouse Field Operations Guide in April and May of 2009 as a response to the emerging H1N1 outbreak. ♦ Operation Sweat Socks: November 20, 2008: Full scale exercise focusing on a mass casualty incident at Davis Monthan Air Force Base and the rapid triage and transport of patients to area hospitals. ♦ Operation Perfect Storm: A table-top exercise facilitated by local hospitals testing plans for sustainment and interoperable communications during a mass power disruption and interference with other critical services. ♦ A multi-POD, full scale exercise for the Pima County Citizens Corp Council testing the mobilization of POD supported by Medical Reserve Corps, Volunteers-in-Police Service and Community Emergency Response Teams. The exercise was multi-agency and multi-county in scope. ♦ A foodborne illness (FBI) tabletop exercise took place on June 12, 2009. The outbreak scenario addressed incident command structure during investigations into a multijurisdictional FBI outbreak. Pima Animal Care Center Pima Animal Care Center (PACC) Protects the public health and safety for people and animals by enforcing rabies control, welfare laws and cruelty ordinances. PACC employees and volunteers work diligently to place adoptable animals into safe and loving homes. Program Goals ♦ Reduce the risk of diseases and injuries caused by wild and domestic animals. ♦ Maximize the care of companion animals waiting for adoption and/or rescue. ♦ Reduce the impact of companion animals on urban lifestyles through spay and neutering. Programs Program Accomplishments ~ Adoption ~ Enforcement ~ Outreach and Education ♦ A total of 27,243 animals were brought to the shelter representing an increase of 13 percent over last year. ♦ Issued 104,056 dog licenses. ♦ A total of 8,918 animals were saved or rescued. ♦ Adoptions: 4,282 ♦ Returned to owner: 1,986 ♦ Rescued animals: 2,650 Services Provided Rabies control Bite reports / investigations Leash law violation Dangerous dog evaluation Patrol requests Animal noise / waste complaints License enforcement Assist law enforcement Enforcement ♦ The 28 enforcement officers drove more than 400,000 miles and responded to over 37,000 field service calls within Pima County. ♦ Typical field service calls include bite investigations, animal welfare or cruelty concerns, loose animals, noise and waste complaints. ♦ A total of 4,145 citations were issued. Outreach and Education ♦ Partnered with PetSmart to host an adoption clinic for adoptable shelter animals. ♦ Coordinated additional off-site adoption events with Muttropolis at La Encantada Mall. ♦ Participated in 115 community-wide health fairs and educational forums and outreached to over 10,000 individuals with educational material and program awareness. ♦ Organized educational volunteer and outreach events involving local school children. ♦ Presented an animal at the ‘Pause for Paws’ program twice a month at the Pima County Board of Supervisors meeting. ♦ Partnered with KOLD Channel 13 “Tuesday’s Tail” which highlights adoptable pets from the shelter. The Animal Shelter Expansion Continued The project completion is expected for fall of 2009. The expansion will have an additional 28,740 square feet of shelter area, 30 new indoor/outdoor adoption kennels, four new visitation yards and a new cat adoption area. Upgrades are underway for the original facility to include upgrading the air conditioning and drainage system. No adoptable animal has been euthanized since 2002 Health Promotion and Education Consumer Health and Food Safety Contributes to the community’s health and the well-being of Pima County residents through inspection, investigation and enforcement of public health laws pertaining to food service establishments, swimming pools, hotels, motels and mobile home parks. Inspections are conducted to assure proper procedures are in place and establishments meet regulatory compliance. Programs ~ Consumer Health and Food Safety ~ Community Nutrition Programs ~ Tobacco Prevention and Education ~ The Physical Activity Program Program Accomplishments Consumer Health and Food Safety provides regulatory oversight through a delegation agreement with the Arizona Department of Health Services and the Arizona Department of Environmental Quality for the following types of businesses and facilities. Inspections Performed ♦ Food Establishments ♦ Hotel/Motel/Mobile Home or RV Park ♦ Public Swimming Pools, Wading Pools or Spas ♦ Semi-Public Pools and Spas ♦ Public Elementary, Middle and High Schools ♦ Complaints Total Inspections Performed Licenses Issued ♦ Food Service Establishments ♦ Temporary Food Establishments ♦ Public and Semi-Public Pools & Spas ♦ Mobile Home and RV Parks ♦ Public School Inspections of Buildings ♦ Bottled Water Plants Total Licenses Issued 5,666 437 66 1,003 264 880 8,316 4,362 1,123 2,481 416 247 2 7,698 Inspectors conducted compliance inspections for the Smoke-Free Arizona Act which prohibits smoking inside most enclosed public places and places of employment and within twenty feet of entrances, open windows and ventilation systems. Vector Control Vector surveillance and control activities are performed throughout the year in collaboration with community businesses and neighboring municipalities. An aggressive community-wide educational campaign continued to reduce the number of mosquito breeding sites and increase community awareness of potential disease transmission. ♦ ♦ ♦ A total of 17 of West Nile virus cases were reported with the first human case in August 2008. There were no equine cases reported. Diligent efforts are continuing to perform surveillance and control activities in conjunction with community education and awareness campaigns. Both are necessary to address vector borne illness and disease in Pima County. Health Promotion and Education Community Nutrition Programs Promotes healthy eating habits for pregnant women, new moms, infants, children and seniors. Federally-funded services are provided to recipients through the Women, Infants and Children (WIC) Program and FOOD Plus. Women, Infants and Children Program Programs ~ Consumer Health and Food Safety ~ Community Nutrition Programs ~ Tobacco Prevention and Education ~ The Physical Activity Program The WIC Program is a federally-funded supplemental nutrition program that provides low-income pregnant women, new mothers, infants and children under 5 years old with nutrient-rich food; nutrition and health education; growth monitoring; and referrals to health and social services programs in our community. A significant emphasis of the program is breastfeeding support and education. Breastfeeding provides better nutrition and digestibility for the infant; enhances the baby’s immune system building a solid foundation for good health; improves weight management for mothers; positively affects the bonding between mother and infant; and is less expensive than purchasing formula. Program Accomplishments ♦ Distributed $10.9 million in federally-funded food and infant formula to certified program recipients. ♦ Provided services to 171,483 clients of service to include 42,808 breastfeeding and postpartum women; 46,845 infants; and 81,830 children ages five and under. ♦ Provided individual health and nutritional education sessions to 49,808 clients. These educational sessions are offered by Health Educators, Senior Community Nutrition Specialists, Community Nutrition Specialists and Registered Dietitians. ♦ Distributed a year’s supply of multi-vitamins containing folic acid to prevent neural tube defects, including spinal bifida to 3,011 individuals. ♦ In addition to providing supplemental foods, provided 514 hospitalgrade and 178 personal breast pumps. FOOD Plus Is the Commodity Supplemental Food Program (CSFP) funded through the USDA providing eligible families with a food package rich in protein, calcium, iron and Vitamins A & C. Eligible participants are pregnant women, new moms up to one-year post partum, children five years old and under who are NOT on WIC; and seniors over 60 who qualify for the food packages. Program Accomplishments ♦ This food supplement program, provided 38,692 food packages to 47,838 eligible recipients enabling them to receive monthly assistance to put healthy, nutritious food on their tables. Health Promotion and Education Tobacco Prevention and Education Assures that Pima County residents are encouraged to engage in healthier lifestyles and participate in smoking cessation services to help reduce tobacco use among young people and adults through education and support services. Program Accomplishments ♦ ♦ ♦ Teachers at 157 elementary and middle schools were provided evidence-based curricula and training to implement a tobacco education and healthy lifestyles program. The program promoted resiliency awareness techniques, addiction risks and refusal skills. Students Working Against Tobacco, or SWAT, pledge to promote healthy lifestyles through a variety of community tobacco awareness activities geared towards youth. The youth coalition was comprised of 300 students belonging to one of 27 charter schools. After conducting a community needs assessment, a Community Networking Program was developed. Community business organizations were offered health education based on identified needs. ♦ ~ Consumer Health and Food Safety Training for cessation facilitators to conduct cessation classes within their organization was provided. ♦ ~ Community Nutrition Programs Materials and training for tobacco users regarding tobacco etiquette was made available. ♦ Proactive referral training to the statewide Quit-Line was conducted. Programs ~ Tobacco Prevention and Education ~ The Physical Activity Program Smoke‐Free Arizona Staff responded to 598 community complaints of the ARS 36.601.01 Smoke‐Free Arizona Act. Inspections were conducted to verify the complaints and where indicated, education regarding compliance with this statue was provided. Each confirmed violation received a follow‐up inspection. The Physical Activity Program Promotes active lifestyles for 4th through 8th graders, and their families. Participants are encouraged to make healthy lifestyle choices to reduce the onset of chronic diseases in children. Program Accomplishments ♦ Staff trained teachers to incorporate 15 to 30 minutes of exercise into a daily routine. ♦ Over 2,000 children participated in the Physical Activity Program. ♦ A total of 100 adults from selected neighborhoods participated in classes and the Walk Everyday Live Longer (WELL) Arizona Program that offered education and tips on how to improve their physical abilities through activity. Chief Medical Officer Programs ~ Chief Medical Officer Chief Medical Officer (CMO) Is an integral position within the Health Department assuring that all clinicians and division managers are aware of the medical complexities that arise during a public health crisis. ♦ Responsible for assuring compassionate, high quality, public health services to Pima County residents through diligent quality management and hands-on involvement of the services provided. ♦ Assures that clinicians are provided with the most current medical practices to provide quality care services to residents who present to our clinics. ♦ Responsible for the medical oversight and recommendations for disease and outbreak investigation conducted by the department. ~ Public Health Clinicians ~ Laboratory Compliance Public Health Clinicians Under the medical direction of the Chief Medical Officer, Health Department clinicians provide quality public health services to Pima County residents who present to Family Planning, Public Health Nursing, HIV and STD, Tuberculosis, Well Child Care, and Well Woman Healthcheck clinics. Program Accomplishments ♦ Coordinated during the initial investigation, surveillance and response to the novel influenza A H1N1. ♦ Researched and created fact sheets for local medical providers about H1N1. ♦ Provided clinical direction for the volunteer medical staff responding to the community threat of H1N1. Laboratory Compliance Assesses and assures compliance within applicable Health Department programs regarding requirements and regulations for federal, state and local laws. Program Accomplishments ♦ Provided more than 14 training sessions for staff that included CLIA, OSHA and HIPAA education. Public Health Nursing Public Health Nursing Works with communities to resolve public health concerns and improve the health of Pima County residents. Nurses provide individuals and families with services that promote health and prevent disease. Programs ~ Clinics ~ Childcare Health Consultants ~ Student Interns and Volunteers ~ Car Seat Safety ~ Home Visits/Case Management ~ Dental Sealant ~ Mobile Dental ~ Early Childhood Oral Health Public Health Nurses response to Swine Flu In April of 2009, the threat of the novel influ‐ enza A virus became a reality. Public Health Nurses staffed a call cen‐ ter to respond to the public’s need for information about this emerging disease. Program Accomplishments Clinic Visits ♦ Provided services for 26,167 residents. ♦ Provided 56,395 vaccinations. Childcare Health Consultants ♦ Developed high quality, effective training and resources on health and safety for local child care programs. ♦ Provided 35 educational in-services and presentations to child care programs. Over 900 individuals attended. ♦ Consulted with and evaluated child care programs and identified 96 targeted intervention opportunities to educate and improve Back to School Summer processes. Immunization Clinic Student Interns and Volunteers In the month of August, ♦ Nurses mentored over 50 student interns to help the Public Health Nurses develop future workforce and foster understanding organized the annual and interest in Public Health Nursing. “Back to School Immunization Clinic” Car Seat Safety Program using the incident command structure. ♦ Provided car seat safety and education class to 362 The clinic was held at the families with children five years old and younger. Tucson Convention Center ♦ Distributed 239 car seats. over eight different days Home Visits/Case Management including weekends and ♦ Conducted over 7,000 in-home visits to residents weekday nights to increase of Pima County needing supportive medical case accessibility for parents management to enable them to live preparing their children for school. independently. A total of 7,763 children Children Vaccinations received vaccinations this year. The following is a snapshot of the children who received vaccinations: ♦ 1,658 infants to age two ♦ 2,500 two to five years of age ♦ 4,533 elementary age children ♦ 3,357 middle and high school age children Mobile Dental Program Has a mobile dental unit equipped with two complete dental operatories, sterilization and digital x-ray equipment. ♦ Non-profit agencies provided comprehensive dental services to rural area communities using the mobile dental unit. Early Childhood Oral Health Program Is funded by the United Way of Tucson and Southern Arizona. ♦ Oral screenings and fluoride treatments were provided to 525 infants and children up to age five. ♦ Parents and childcare staff received education regarding the importance of early oral health care. Dental Sealant Program Is a school based program funded by the Arizona Department of Health Services, Office of Oral Health. ♦ Since 2002, 10,000 children have participated in the program. ♦ This year, 1,300 second and sixth grade children received dental screenings and sealants in the Amphitheater, Flowing Wells, Sunnyside, Marana and Tucson Unified school districts. Administrative Services Finance Endeavors to provide efficient, cost effective administrative support for public health programs for budget development and monitoring, accounting and financial reporting, contract processing, warehouse management, and information technology support. Staff coordinate federal, state and local audit responses demonstrating full programmatic and administrative compliance. Programs ~ Finance ~ Personnel ~ Information Technology Program Accomplishments ♦ In response to a significant decline in the economy during this fiscal year, the County Administrator required all departments to submit a revised expenditure budget plan mid-year that reduced aggregate departmental expenditures by 2.5 percent for the balance of the fiscal year. The revised expenditure budgets were analyzed and presented to the Pima County Board of Supervisors for their review and action in January 2009. ♦ Successfully passed an audit of the Health Department’s federally funded programs conducted by the Arizona Office of the Auditor General. ♦ Monitored and reported on 77 federal, state and privately funded annual grants totaling over $8.7M to ensure compliance with governing directives and budgets. Personnel Supports over 300 employees in understanding and using their benefits. Staff assists management with filling vacant positions, and submitting the required paperwork for promotions, transfers and new staff hiring. Updates and changes to personnel policies and procedures are provided to all employees. Information and Technology ♦ Staff conducted an internal review to develop a strategic plan that reduced duplication, costs and staff time through use of technology. ♦ Health Department staff participated in a countywide website revitalization project that will improve the County’s ability to provide information to the community in an improved user-friendly, web-based medium. Office of Emergency Management and Homeland Security The Office of Emergency Management & Homeland Security (OEMHS) Strives to prevent the loss of life and reduce property damage due to man-made, technological and natural disasters within Pima County in accordance with ARS Title 26 and Pima County Code Title 9. OEMHS acts as a facilitating and coordinating agency for disaster response. OEMHS provides professional emergency management services that include prevention, protection, response and recovery activities. Program Goals ♦ Coordinate activities and training to protect lives, property, and the environment in the event of a disaster. ♦ Develop County emergency response and mitigation plans. ♦ Assist municipalities and local governments in developing their plans to ensure the highest level of individual and agency preparedness for disaster response and recovery. ♦ Perform all emergency management tasks required by law and local mandate. ♦ Comply with Homeland Security Presidential Directives, National Incident Management System (NIMS) and National Response Plan (NRP), National Infrastructure Protection Plan (NIPP), and National Preparedness Goals and Guidance. Program Accomplishments ♦ Received $129,000 through the Emergency Management Performance Grant administered by the Arizona Division of Emergency Management. ♦ Received approximately $290,000 from the Department of Homeland Security Grant program for personnel costs.