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Department of Health Madison County

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We, the Madison County Department of Health,

promote and protect the health of our community through

assessment, education, and by ensuring necessary services.

Working within a network of partners, we strive to meet

the health needs of Madison County.

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The Madison County Board of Health

is honored to have the opportunity to

serve the citizens of Madison County.

We will continue to work hard to en-

sure that essential public health ser-

vices are provided to our community.

“Life is not merely being alive, but be-

ing well.” - Marcus Valerius Martialis

For improving our community health,

we promote a health strategy of well-

ness through all stages for life, from

infancy to older adulthood. This ap-

proach aims to help people maintain

good mental and physical health

throughout their lives. Our goal is for

everyone in the community to have

the highest possible quality of health

through every stage of their lives. By

doing so, people will be able to live

their optimal life expectancy.

While promoting wellness throughout

life does not focus on specific diseases

or conditions, health care needs and

disease will always exist and must be

addressed. We continue to evaluate

and develop strategies regarding the

primary causes of preventable disease

and death, primarily tobacco use and

unhealthy weight.

Tobacco use is still the leading cause

of preventable morbidity and mortali-

ty. There needs to be continued ef-

forts in education regarding tobacco

use and its responsibility for multiple

types of cancer, lung disease, heart

disease, stroke and detriment to re-

productive health. The health of the

community can be much improved by

reducing tobacco use and reducing

secondhand smoke exposure.

Overweight and obesity have been

shown to increase the likelihood of

certain diseases and other health

problems. They are important con-

cerns for adults, children, and adoles-

cents in our community. The con-

sumption of healthful diets and the

achievement and maintenance of

healthy body weights are necessary to

promote health and reduce chronic

disease. Achieving and sustaining ap-

propriate body weight across the

lifespan is vital to maintaining good

health and quality of life. Body weight

is affected by many behavioral, genet-

ic and environmental factors, but the

key to weight management is calorie

balance over time. Calorie balance as

defined by the 2010 Dietary Guide-

lines for Americans is the relationship

between the calories consumed from

foods and beverages and the calories

expended in normal body functions

and through physical activity. By living

active lifestyles, our community will

improve health, fitness, and quality of

life.

“All public health is local - it’s got to

start and be sustained at the local lev-

el.” - Howard Koh

The Board of Health will continue to

work with other community members

- the Department of Health, the Madi-

son County Board of Supervisors and

community partners - to address the

unique health needs of the diverse

communities in Madison County.

Working together and with input from

our communities will foster innovation

and allow the adoption of appropriate

protections and solutions.

An example of incorporating unique

solutions is a community’s decision to

apply the principles of Smart Growth

for land use planning. Smart Growth

principles assist the local decision

making process of how to develop and

preserve the community’s natural en-

vironment, promote its economic

growth, create a range of housing

choices for its residents, and promote

a healthy, active lifestyle. Implement-

ing these principles helps a communi-

ty to build a place where people want

to live and visit, and preserve the

qualities people love about their com-

munity.

Our activities will continue to adapt to

meet the evolving needs of our com-

munity. We ask that you get involved,

take charge of your health and con-

tribute to our community’s health.

Thank you for wanting to be a part of

a healthier Madison County.

Dr. John B. Endres

President, Board of Health

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It is my pleasure to present the Madi-

son County Department of Health’s

2012 Annual Report. The year 2012

marks a time of noteworthy changes

and exciting challenges for public

health in Madison County.

2012 marked the final chapter for the

County’s Certified Home Health Agen-

cy. On March 13, 2012 the County

ended its CHHA program. HCR of

Rochester assumed the daily provision

of home care services in Madison

County thereby ensuring that our resi-

dents will continue to receive the care

they need.

The Department welcomed the addi-

tion of the County’s Weights and

Measures program into our Environ-

mental Health Division. The addition

of Weights and Measures program

compliments and expands the scope

of services provided through our envi-

ronmental health division, while ad-

vancing the County’s goal to stream-

line government services and reduce

costs to local residents.

International attention was directed

towards CNY as a focal point of “bath

salts” use with the unfortunate death

of a local resident. Over a period of

several months, local hospitals experi-

enced a surge in emergency room vis-

its from individuals reeling from the

effects of these drugs, while local law

enforcement officers were seeing an

increase in public safety issues. The

Health Department joined with elect-

ed officials, health care providers, law

enforcement , schools, community

organizations and concerned citizens

to form a Bath Salts Task Force to ad-

dress this growing public safety and

health issue in our communities.

Through this collaborative effort,

Madison County was successful in ef-

fecting positive change that resulted

in a decrease in public safety issues,

emergency room visits, and synthetic

drugs sales , while expanding the

awareness of this issue through a con-

siderable community education and

outreach initiative.

On a national level, the third publica-

tion of the National County Health

Department Ranking report showed

that Madison County continued to

improve its ranking among New York

Counties by ranking 10th (23rd in 2010;

16th in 2011) in overall health out-

comes and 15th (25th in 2010; 20th in

2011) in overall health factors.

In 2012 the Department was awarded

grant funding from the federal Health

Resources and Services Administration

(HRSA) to establish the Madison Coun-

ty Rural Health Council, a formal rural

health network comprised of local and

regional health care providers that will

focus their efforts on bringing needed

primary and preventive medical, den-

tal and behavioral health care services

to our residents. The Department also

received a grant from the Health

Foundation for Western and Central

New York that compliments the HRSA

project through a capacity building

initiative that includes the completion

of a community health assessment

and development of the next County

Health Improvement Plan.

The Health Department received one

of five EPA Smart Growth Technical

Assistance Grants offered nationally.

The Department, in partnership with

the Madison County Planning Depart-

ment, the City of Oneida Planning De-

partment, USEPA, and the Renais-

sance Planning Group, a nationally

recognized planning firm, will develop

a Smart Growth Audit Tool for Madi-

son County municipalities to facilitate

their local planning and economic ac-

tivities, while fostering healthy com-

munity development. The tool, once

completed will become a national

model for rural communities.

These are but a few of the many areas

in which both individual and collabora-

tive efforts of Madison County Depart-

ment of Health personnel, working

alone and in concert with numerous

agencies and organizations, furthered

our aim of working to build a healthier

community.

I am proud of our dedicated and high-

ly trained public health employees

who continually strive to provide com-

passionate, quality service to our com-

munity. As always, the health and

well-being of communities does not

rest upon the shoulders of the health

department alone, but is dependent

on all of us, working together to en-

sure the conditions in which our fami-

lies can be healthy.

To your health,

Eric Faisst, MPH

Director of Public Health

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Source: County Health Rankings and Roadmaps: www.countyhealthrankings.org

Madison County Madison County 2011

Rank

Madison County 2012

Rank

New York National 2010

Rank 2010 2011 2012 2012 Benchmark

HEALTH OUTCOMES 23 16 10

Mortality 19 12 11

Premature death 5,818 5,431 5,250 5,650 5,317

Morbidity 34 26 15

Poor or fair health 14% 13% 14% 15% 10%

Poor physical health days 3.5 3.4 3.3 3.5 2.6

Poor mental health days 3.5 3.4 3.0 3.4 2.3

Low birth weight 7.2% 7.3% 6.7% 8.2% 6.0%

HEALTH FACTORS 25 20 15

Health Behaviors 47 35 21

Adult smoking 27% 26% 23% 18% 13%

Adult obesity 27% 27% 27% 25% 21%

Excessive/binge drinking 17% 14% 23% 17% 7%

Motor vehicle crash death rate 16 17 13 7 10

Sexually transmitted infections 167 162 166 516 92

Teen birth rate 19 19 17 25 21

Clinical Care 21 19 22

Uninsured 15% 17% 11% 14% 11%

Primary care physicians 115 865:1 1,749:1 1,222:1 1,067:1

Dentists - - 3,023:1 1,414:1 1,516:1

Preventable hospital stays 73 74 72 66 47

Diabetic screening 82% 82% 85% 85% 90%

Mammography screening - 70% 76% 66% 73%

Social & Economic Factors 14 15 12

High school graduation 80% 85% 85% 77% -

Some college 24% 59% 59% 64% 70%

Unemployment 6.0% 8.0% 8.1% 8.2% 5.0%

Children in poverty 15% 17% 18% 23% 14%

Inadequate social support - 19% 19% 24% 14%

Children in single-parent households 10% 30% 32% 34% 20%

Violent crime rate 101 89 81 391 66

Physical Environment 11 28 25

Daily fine particle matter - - 10.8 10.9 8.8

Drinking water safety - - 14% 4% 0%

Access to recreational facilities - 11 10 11 16

Limited access to healthy foods - - 5% 2% 1%

Fast food restaurants - - 35% 45% 27%

State of Health in Madison CountyState of Health in Madison County

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Thanks to funding from the Hamilton-Bassett-Crouse Health Network, the Health Department was able to bring back the popular Eating Well with Dia-betes and Take Charge of Your Diabe-tes Programs, which had not been held since funding from the New York State Department of Health Diabetes Prevention and Control Program end-ed in 2009. Since Madison County has limited services for diabetes manage-ment, the department was pleased to able to provide people with Type 2 diabetes access to a Certified Diabetes Educator and Registered Dietician to help them manage their disease. The department recruited Office for the Aging, Inc. to partner on Eating Well with Diabetes, a free nutrition education program. Office for the Ag-ing provided a Registered Dietitian to plan and facilitate the six sessions,

which cover serving sizes, food label reading, menu planning, carbohydrate counting, and healthy cooking. The program was held at Office for the Aging in Canastota in the Spring and the Fall. The Health Department worked with Office for the Aging to plan and promote the program. Or-ganizers plan to offer the program in Hamilton in Spring 2013. Take Charge of Your Diabetes is a two-session program led by a Certified Dia-betes Educator. The department host-ed the program in the Spring of 2012, which focused on the healthy lifestyle behaviors of “Getting on Track with Physical Activity” and “Good Nutrition to Manage Your Diabetes”. Participants are asked to complete an evaluation for each session, which helps organizers both improve the

program and helps determine that it is working to improve participants’ knowledge and skills in managing their disease. Participants have shared that they benefit from the group setting where others are sharing their same concerns. Many participants also rec-ognize that it is not enough to receive this type of education only once, but that they need on-going access and exposure to education and support.

DIABETES SELF-MANAGEMENT PROGRAMS

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The Health Department, as part of the Madison County Employee Assistance Program (EAP) Committee, spearhead-ed the effort to bring a farm stand to Wampsville for the 2012 growing sea-son. In an effort to increase access to fresh produce for county employees, village residents, and visitors, the de-partment arranged for Stone Brothers Farm of Canastota to set up a farm stand at the Wampsville Fireman’s Field Park Building parking lot on Fri-days from 3:00-6:00 for six weeks through August 31st. This partnership gave county employees the opportuni-ty to purchase locally grown produce at their worksite while supporting lo-cal farming. As a result of partnering on this pro-ject, Stone Brothers Farm offered to start a new pick up site in Wampsville for their Community Supported Agri-culture (CSA) Program for the 2013 growing season. The Health Depart-ment promoted this new opportunity and enough interest was generated to start the program in Wampsville. Those interested may sign up for a full share, which feeds 2-4 people with a balanced diet, or a half share, which feeds 1-2 people. For 22 weeks, CSA members will receive a bountiful bag filled with a variety of vegetables, which are free of pesticides and insec-ticides.

WAMPSVILLE FARM STAND

“Public Health is what we as a society do

collectively to assure the conditions in which people

can be healthy.”

Institute of Medicine 1988

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Local Law Prohibits Smoking on Local Law Prohibits Smoking on

County PropertyCounty Property

The Madison County Board of Supervi-sors’ Public Health Services Standing Committee charged the Health De-partment with the goal to make coun-ty-owned and leased property tobacco-free. On September 11th, 2012 Local Law #4-2012 “ was adopted by the Madison County Board of Supervisors. Local Law #4, which prohibits the use of tobacco upon real property owned or leased by Madison County, was en-acted to protect the public’s health, safety and general welfare by elimi-nating exposure to second-hand to-bacco smoke and tobacco resi-due. Madison County parks and forest lands were exempted in the local law. Signs were provided by our partners at BRiDGES and erected on County property. Tobacco Awareness CampaignTobacco Awareness Campaign ——

Tobacco DisplaysTobacco Displays The Board of Health directed the de-partment to explore a Tobacco Prod-ucts Display ban, which would require tobacco retailers open to minors to keep tobacco products out of sight.

The Board has a strong interest in pro-tecting adolescents from tobacco de-pendence and subsequent illnesses and premature death associated with tobacco use. Research shows that dis-plays of tobacco products increase the likelihood that youth will start smok-ing. The Board desired to reduce ado-lescent smoking and the public health consequences without prohibiting the sale of tobacco products to adult con-sumers. MCDOH worked with BRiDGES, Madi-son County Council on Alcoholism and

Substance Abuse staff, and youth members of Reality Check to produce a six-month awareness campaign about the harmful effects of tobacco. The awareness campaign and its nu-merous contributors produced a se-ries of pieces about tobacco online, in newspapers, radio, and on television that educated on the deceptive mar-keting practices by the tobacco indus-try, what parents can do to protect the health of their children, health effects of secondhand smoke in chil-dren witnessed by a local pediatrician, and what we can do locally to prevent youth from starting to smoke. The campaign also introduced the commu-nity to the proposed Tobacco Prod-ucts Display ban. The Department visited 51 tobacco retailers in the county to inform them of the proposed display ban and to get their feedback. Three tobacco retail-ers presently keep tobacco products out of sight. While the Board decided to not pursue a local law, they were encouraged by the willingness of local businesses to move in the direction of protecting our youth from tobacco marketing techniques with some indi-cating they will be moving away from selling tobacco in the future.

TOBACCO FREE LIVING

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The Health Department was awarded grant funding ($78,000) from the fed-eral Health Resources and Services Administration (HRSA) to establish the Madison County Rural Health Council (MCRHC), a formal rural health net-work comprised of local and regional health care providers that will focus their efforts on bringing needed pri-mary and preventive medical, dental and behavioral health care services to our residents. The Department also received a grant from the Health Foundation for West-ern and Central New York ($47,000) that compliments the HRSA project through a capacity building initiative that includes the completion of a com-munity health assessment and devel-opment of the next County Health Im-provement Plan. In October, 2012 the Madison County

Health Department (MCHD) launched a community process with the inten-tion of organizing an independent not-for-profit Rural Health Council to en-gage in system-wide communication, collaboration and economic develop-ment linking health care providers with social service agencies, educa-tional institutions and businesses throughout the county and surround-ing areas of Central New York.

The network will perform a host of functions and services that no other entity in Madison County has ever provided. One of the key functions will be its ability to facilitate discussion and coordinate action by numerous agencies in a neutral way. The net-work will take on the task of collect-ing, managing and analyzing data on both regional and county levels for health care organizations, providers,

MADISON COUNTY HEALTH CARE INITIATIVE

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and consumers. The network will oper-ate as a focal point to assist members and the community and will provide a unified voice as it navigates the chang-ing health care environment. In addition to its data management

function, the network will improve access to quality primary preventive care and help consumers and provid-ers monitor and manage chronic dis-ease. These two issues are paramount to the health of the community and

are too broad for any one entity to take on alone. Improvements will more likely be achieved through a col-laborative effort that is led and coordi-nated by a neutral party that repre-sents the interests of all players.

HEALTH LITERACY FOR FAMILY HEALTH CARE PROVIDERS

In partnership with the Hamilton-Crouse Health Network and Morris-ville State College Baccalaureate School of Nursing Program, the Health Department initiated a Health Literacy Project with the family practice pro-viders of Community Memorial Hospi-tal. With input from provider offices (56 surveys from 9 provider offices), the project team developed Health Litera-cy Improvement Manuals containing information, tools and other materials to assist the providers to deliver health information in ways that are understandable for their patients. The team presented individualized survey results and provided staff training on the use of the Health Literacy Im-provement Manual to each participat-ing provider office. The presentation

offered practices a way to assess their services for health literacy considera-tions, raise awareness of the entire staff, and work on improving specific areas. Health literacy is as important for healthcare providers, and their staff, as it is for patients. To bridge the gap between the medical information pro-vided and its implementation, we need health professionals who are able to speak the language and under-stand the culture of their patients. Each provider has the opportunity to positively impact the lives of many individuals by providing health infor-mation to their patients in a manner that empowers their patients to take better control of their health. The nine provider offices we worked with

see an average of 600 to 11,440 pa-tients a year. Our goal is to involve all provider offices in this initiative and positively impact our community. The Health Literacy for Family Health Care Provider Project helped to facili-tate changes in the health care system that will help to improve health infor-mation, communication, informed decision making, and access to health services.

BREASTFEEDING CONNECTIONS CAFÉ The Madison County Healthy Start Partnership, which is led by the Health Department and includes other organ-izations who serve women and chil-dren, such as WIC, Oneida Healthcare Center, Community Action Partnership for Madison County, and REACH CNY, strives to promote and support breastfeeding. Baby weigh stations, known as Breast-feeding Connections, are open weekly in Oneida and Morrisville and are staffed by Certified Lactation Consult-ants from members of the partner-ship. New moms may have their in-fants weighed and get their questions about caring for their infant an-swered.

In 2012, the Healthy Start Partnership decided to add the Breastfeeding Con-nections Café, which had additional success in supporting new moms in neighboring counties. Two Fridays each month, the Breastfeeding Con-nections Café is open at Oneida Healthcare Center. A light lunch is served and alongside lactation helpers from the Healthy Start Partnership, moms are given the opportunity to talk to other moms and connect to community resources in a relaxed set-ting. About six to eight moms visit the Café each Friday. It has been a very positive experience for the moms, who come for the camaraderie, as well as the chance to weigh the baby.

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“Trails of Madison County” map sets were published in 2012 and distribut-ed to the local trail organizations and through Madison County Tourism. A partnership between Madison Coun-ty Planning Department, Madison County Public Health Department, and representatives from several nature trail groups throughout the County culminated with the production of the “Trails of Madison County” map set. These maps highlight the various trails (hiking, biking, horse and snow-mobiling, etc.) in Madison County along with local restaurants and near-by retail establishments. The purpose of the Trails initiative was to increase the use of the County’s recreational assets, foster tourism, stimulate revenue for local businesses, and encourage physical activity. The Department was awarded a Cen-

tral New York Community Foundation grant for the production of 6,500 map sets. The map set highlights 15 differ-ent trails throughout the County. A great addition to the printed trail maps are square bar codes called QR tags or Quick Response codes that work with smart phones to access ad-ditional information. QR tags for local restaurants and businesses, DEC maps, associated Facebook© pages, wildlife guides and more are included in the set of trail maps. Initial review of the outcomes of the Trail project indicates that the maps had a positive impact on increased trail usage and volunteerism. Madison County Tourism noted a significant increase in web site activity especially on the trails page. You can also view the maps digitally, by simply down-loading an “ArcGISonline” application to your smart phone. Happy Trails!

Madison County Tourism http://www.madisontourism.com/ Madison County Planning Department http://www.madisoncounty.ny.gov/planning/

TRAILS OF MADISON COUNTY MAPS

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The Madison County Departments of Health and Planning, along with the City of Oneida’s Planning Department submitted a grant application to the US EPA Smart Growth Implementation Assistance Program for technical assis-tance in developing a smart growth toolkit for Madison County. Madison County was one of only five communities in the entire Country chosen to receive this technical assis-tance funding. Working with USEPA and the Renais-sance Planning Group, a national plan-ning consulting firm, Madison County will develop a smart growth tool that would help our municipalities assess whether their comprehensive plan-ning documents and land use regula-tions support smart growth develop-ment and identify potential changes in these documents that could bring them closer to that objective. After several years of information gathering, research, and public en-gagement, the County concluded that implementing smart growth approach-es to development would help to ad-dress our health, economic, and envi-ronmental challenges and support our stated vision of “a place of natural beauty where families and individuals thrive.” We expect the tool to be finalized in 2013 and believe that this project will have an impact well beyond the bor-ders of Madison County. EPA will share the audit tool with rural commu-nities across the country that are look-ing for smart growth approaches to strengthen their economies, improve quality of life for residents, and pro-tect their rural character.

MADISON COUNTY RECEIVES EPA SMART GROWTH IMPLEMENTATION ASSISTANCE (SGIA)

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Over a period of several months in early 2012, local hospitals experienced a surge in emergency room visits from individuals reeling from the effects of “bath salts”, while local law enforce-ment officers were seeing an increase in public safety issues. The Health De-partment joined with elected officials, health care providers, law enforce-ment, schools, community organiza-tions and concerned citizens to form a Bath Salts Task Force to address this growing public safety and health issue in our communities. A letter from the Bath Salt Task Force urged Governor Cuomo to pass state legislation banning these substances. On August 7, the NYSDOH Commis-sioner of Health issued a commission-er’s order banning the sale and pos-session of synthetic drugs. The Com-missioner’s order required local health departments to ensure that these drugs were removed from local retail stores. The Health Department,

through its Environmental Health Divi-sion worked with local law enforce-ment officials to carry out this order. Subsequently, three of the four local businesses responsible for the sale of these harmful drugs closed their doors, with further court action being initiated against the owner of the forth facility. On September 11, 2012 the Board of Supervisors passed resolution Local Law No. 5 entitled – The Madison

County Ban on the Sale and Posses-sion of the Synthetic Drug Known as Bath Salts. Through this collaborative effort, Madison County was successful in ef-fecting positive change that resulted in a decrease in public safety issues, emergency room visits, and synthetic drugs sales , while expanding the awareness through a community edu-cation and outreach initiative.

SYNTHETIC DRUGS/BATH SALTS

A place of natural beauty

where families and individuals thrive

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2012 ADMINISTRATIVE HIGHLIGHTS Finished Year End 2012 under budget . Reducing County costs by 9%.

Reorganized support staff responsibilities to adjust to the changes resulting from the closing of the home care pro-

gram. Many workers learned new roles and adapted to new programs.

Successfully transitioned to the NYSDOH required 5010 electronic Medicaid billing format.

Worked with our software vendor to enhance our Medicaid billing capabilities for Preschool program.

Reconfigured the Front desk/Waiting room area for a safer workplace environment and to better facilitate public

health clinics.

Received NYSDHO approval as a Licensed home care agency and as a Medicare Part B provider.

PROGRAM AREAS Strategic Planning

Data and Records Management

Financial Management

Contract/Grant Management

Employee Safety and Healthy Work Environment

Clerical Support

The Administrative Services Division provides critical opera-tional support to the four service-based divisions of the Health Department:

Children with Special Health Care Needs

Environmental Health

Health Promotion

Preventive Health

The Administrative Services division serves the entire depart-ment by maintaining centralized cost accounting functions, oversight and direct support of departmental personal and payroll activities, budget development and financial planning, communications and information security, HIPAA and Corpo-rate Compliance, preparation and submission of internal and legally mandated reports, and interpretation and distribution of emerging legislative and policy information.

Mission The Administrative Division strives to provide proactive support to ensure programs function at the maximum level

of cost effectiveness and efficiency while maintaining compliance with policies and procedures.

Vision Through teamwork all programs will be supported by dedicated staff in a professional manner creating positive

working relationships enabling Departmental viability and administrative efficiency.

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Statement of Revenues and Expenses

4th Quarter 2012

Modified 01/01/12- 12/31/12 Under (Over)

Budget Actual Budget

REVENUES

Public Health Administration 538,136 440,282 97,854

Preventive Health 427,745 454,050 (26,305)

Health Promotion and Planning 235,189 130,512 104,677

Home Care 628,969 650,261 (21,292)

Federal/State Grants 86,541 52,165 34,376

EI Program 407,144 376,532 30,612

Preschool Special Education 1,688,484 1,377,548 310,936

Physically Handicapped Children 16,000 7,651 8,349

Environmental Services 355,129 374,756 (19,627)

Total Revenues 4,383,337 3,863,757 519,580

EXPENSES

Public Health Administration 654,976 591,744 63,232

Preventive Health 696,292 642,116 54,176

Health Promotion and Planning 386,593 258,390 128,203

Home Care 725,372 706,786 18,586

Federal/State Grants 86,999 47,785 39,214

EI Program 814,515 689,139 125,376

Preschool Special Education 3,314,248 2,955,453 358,795

Physically Handicapped Children 25,000 4,613 20,387

Environmental Services 610,085 602,019 8,066

Total Expenses 7,314,080 6,498,045 816,035

COUNTY SHARE

County Share Actual County Actual/Budget

Budget Cost Comparison

$2,930,743 $2,634,288 + $296,455

+ Better than Expected compared to Budget 2012 ACTUAL COUNTY COST

- Worse than Expected compared to Budget

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2012 CSHCN HIGHLIGHTS Developed Early Intervention bookmark containing developmental milestones and healthy habit tips to be utilized

for community education and child find.

Contracted with Bright Starts agency to provide Early Intervention services in the Bridgeport area and with Family

Enrichment Network in Norwich to provide Preschool services.

Worked closely with School Districts and Preschool providers to successfully transition responsibility of preschool

service arrangements from Madison County to School Districts.

Early Intervention program successfully met NYSDOH performance indicators for the July2009-June 2010 time peri-

od.

PROGRAM AREAS Children with Special Health Care Needs Program (birth—21 years)

Early Intervention Program (birth—3 years)

Preschool Program (3—5 years)

Mission Children with Special Health Care Needs provides services to overcome barriers and foster the healthy development

of children and families within the community.

Vision Through collaboration with Health care, Education, Therapeutic and Social Service providers, resources are ac-

cessed to meet identified child and family needs. Our commitment to a family–centered strength based approach provides the foundation for maximum growth and potential.

Children with Special Health Care Needs Program

The Children with Special Health Care Needs Program (CSHCN) provides assistance to families of children with special health care needs who need help in accessing vari-ous health care professionals and other community re-sources. Children with Special Health Care Needs Program assists families in accessing appropriate health care cover-age such as Medicaid, Child Health Plus, Family Health Plus, and other public health insurance. Additionally, the Physically Handicapped Children’s Program (PHCP) pro-vides financial assistance to ensure quality healthcare for chronically ill and physically disabled children. While the PHCP program in Madison County has been discontinued to new referrals, the program will continue to serve those clients currently enrolled until they no longer qualify or need services. Services through CSHCN promote and assist families in the establishment of a medical home. Families, especially those who have children with special health care needs,

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may work with many doctors, nurses, and other health care providers in addition to community agencies such as schools, insurance companies and social services. In a medical home, a primary health care provider and the family work in partnership to assure that all the medical and non-medical needs of the child or youth are addressed.

Early Intervention Program

The Early Intervention Program (EIP) is a family-centered program for disabled or developmentally delayed children birth to three years of age and their families. Services include Evaluation, Screening, Special Education Teacher ser-vices, Occupational, Physical, and Speech therapies. Through the Child Find Program, children who are at risk for devel-opmental delays are monitored and screened. Staff works closely with a child’s primary care provider to monitor a child’s developmental progress. The Early Intervention Program (EIP) continues to actively partner with community agencies to provide services to children and families.

Preschool Special Education Program

The Preschool Program provides services to disa-bled and developmentally delayed children ages 3-5 years. Services include Evaluation, Special Educa-tion Teacher services, Occupational, Physical, and Speech therapies. Services are provided at home or in integrated preschool settings comprised of chil-dren with and without disabilities. The Preschool Special Education Program works closely with School Districts, Head Start, communi-ty wide therapeutic agencies and licensed individu-al professionals. Value Management Consultants (VMC) continues to provide assistance with trans-portation services to children receiving classroom services. Continued participation in Preschool Coali-tion meetings provides regional coordination among neighboring counties, school districts, and therapy providers.

Early Intervention Program 2008 2009 2010 2011 2012

Total # referrals 130 109 131 142 161

# Children served 197 180 195 194 145

3-5 Preschool Special Education Program

# Itinerant served 155 141 171 165 167

# Center based Served 84 56 83 75 69

Physically Handicapped Children’s Program

# Served 88 74 63 43 30

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2012 ENVIRONMENTAL HIGHLIGHTS Engaging in early awareness outreach efforts with the neighboring counties encompassing the Oneida Lake basin and it’s mosquito breeding grounds and promoting an enhanced regional approach to target the prevention of mosquito borne disease, specifically Eastern Equine Encephalitis responsible for human fatalities in 2010 and 2011.

Assisting the Town’s of Lenox, Lincoln and Cazenovia with well water sampling and / or technical support to en-hance financial assistance applications for the extension of municipal water service to areas experiencing poor well water conditions.

The start of construction on the Bridgeport Sanitary Sewer project that will eliminate the use of sub-standard septic systems within the environmentally sensitive areas along the south shore of Oneida Lake, and bring economic growth and residential development along the Town of Sullivan’s Route 31 corridor.

The granting of the first mass gathering permit in Madison County history for the 2012 NYS Country Jam held in Bouckville, an outcome of a multi-agency collaboration that included the Sherriff’s office, NYS Trooper’s, the NYS Department of Transportation, emergency medical services, legal affairs and the Town of Madison.

PROGRAM AREAS Radon Awareness

Lead Paint Hazard Reduction

Internships and Youth Development

Water Supply Protection

Sewage Disposal

Realty Subdivisions

Regulatory Inspections

Food Protection

Community Sanitation

Temporary Residences, Campgrounds, Cottages

Children's Camps

Swimming Pools & Bathing Beaches

Mosquito Surveillance & Vector Control

Clean Indoor Air Act

Regulation of Tanning facilities

Migrant Farm Worker Housing

Adolescent Tobacco Use Prevention Act (ATUPA)

program

Mission Enhance the quality of life in Madison County by implementation of effective and efficient environmental health

programs to protect the public health, safety and the environment.

Vision Essential environmental services shall be provided with honesty, integrity and respect by knowledgeable staff dedi-

cated to excellence and focused on the needs of our community.

Checking on safety of water at mass gathering in Bouckville

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The collaboration with local law enforcement was further engaged in the response to the proliferation of synthetic drug use which prompted the NYS Health Commissioner to ban the sales of bath salts and synthetic cannabis. The Division’s implementation of the Commissioner’s order and engagement with State, County and local law officials prompted the closure of three of the four “head shops” responsible for the sale of these harmful drugs, and further court action being initiated against the owner of the forth facility.

The Division continues to actively monitor the potential impacts related to the pending NYS decision on High Vol-ume Hydrofracking (HVHF), keeping apprised of the environmental considerations prompted by the NYSDEC’s Sup-plemental Generic Environmental Impact Statement and proposed HVHF regulations, submitting comments and concern’s either directly to the NYSDEC and / or through partner agencies such as NYSACHO and the Conference of Environmental Health Directors, and further supporting the need for a comprehensive health impact assessment prior to such decision being enacted.

The Division recognizes the growing popularity and economic importance of our Agricultural community, and con-tinues to assist with the technical guidance and regulatory permitting necessary to further expand those Ag venues important to their respective communities, including the County Fairgrounds, the new Owera Wineries, the ever growing Critz Farms and County sponsored Open Farm events, as well as the highly attended Antique festivals held along the Route 20 corridor each summer.

Responding to the public health threat of the deadly rabies virus endemic to the County continues to be a priority, and in addition to responding to animal bites and wildlife exposures, the Division again conducted rabies clinics in 2012 that provided for the vaccinations of more than 1,850 pet’s. Responding to the rabies threat is expected to be further challenging in 2013 as we experience increasing incidents of rabies effecting our Ag community.

The Environmental Health Division’s chief accomplishment in 2012 was the continued competence exhibited engaging in those daily activities necessary to protect the health of the public, ranging from the closure of a food service estab-lishment found unsanitary and posing a significant risk to patrons, enforcing the State Health Commissioner’s order banning the sale of harmful synthetic drugs, responding to exposures of humans to rabies suspect wildlife and vector borne disease, enforcing the State Sanitary Codes intended to protect drinking water supplies to ensuring that the pub-lic gatherings which highlight Madison County were conducted in a safe, sanitary manner.

Technician Becca Lewis checking on black nesting boxes

used to collect mosquitoes as part of surveillance program

Pet owners lined up for vaccinations at rabies clinic held at

Wampsville Highway Garage

EEE Media event at NYS Fairgrounds

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FOOD PROTECTION

Permitted Inspected % Inspected

High Risk 131 131* 100%

Medium Risk 28 27 96%

Low Risk 169 158 93%

Institutional 82 79 96%

Mobile 15 14 93%

Temporary 262 221 84%

Total # Food Service Establishments 687 630 92%

TEMPORARY RESIDENCES CHILDREN'S CAMPS

Permitted 21 Permitted 9

Inspected 19 Inspected 9

CAMPGROUNDS SWIMMING POOLS

Permitted 17 Permitted 12

Inspected 16 Inspected 9

MASS GATHERING AGRICULTURAL FAIRGROUNDS

Permitted 1 Permitted 1

Inspected 1 Inspected 1

BATHING BEACH MOBILE HOME PARKS

Permitted 11 Permitted 24

Inspected 11 Inspected 24

ATUPA (RETAIL) ATUPA (VENDING)

Active 50 Active 0

Adult Compliance Check 46 Adult Compliance Check Not Applicable

Compliance Check w/Minor 68 Madison County currently has no vending machines in

operation. Enforcement Action 1

CIAA NUISANCES

# of Complaints 2 # of Complaints 81

# of Investigations 2 # Resolved 79

% Resolved 98%

RABIES PROGRAM

# Animal Bites Referrals 185 # Rabies Clinics Offered 12

# Animals Submitted for Testing 59 # Dogs Vaccinated 1350

# Animals Testing Positive 9 # Cats vaccinated 499

# of Animals Quarantines Due to Exposure 18 # GoatsVaccinated 1

# of Human Post-Exposure Treatments 39 # Ferrets Vaccinated 1

# of General Rabies Inquiries 109

ENVIRONMENTAL HEALTH INSPECTIONS/PERMITS/ACTIVITIES

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TANNING FACILITIES PUBLIC WATER SUPPLY

Permitted 10 # of Public Water Supplies 117

Inspected 10 # Inspected/Sanitary Surveys 114

PLAN REVIEWS # of Sampling Visits 159

Engineering Plan Review 70 Community PWS 39

Pool/Beach Safety Plan Reviews 30 Non-Community PWS 61

ENVIRONMENTAL LEAD PROGRAM Non-Transient Non-Community 17

# of Referral Investigations 1 Individual Water Samples Collected 13

# of Referral Invest. closed 1/1-12/31 0 Bathing Beach Samples Collected 21

# Field Visits Blood Lead 9-14 ug/dl 1 SOC/IOC/VOC Samples Collected 10

MOSQUITO SURVEILLANCE PROGRAM

# Mosquito Pools Submitted 183 # Dead Bird Reports/ Hotline 4

# Positive WNV Pools 0 # Birds Submitted 0

# Positive EEE Pools 0 # Positive 0

FOIL (Freedom of Information Requests)

#FOIL Requests 27

(*) High Risk Facilities are inspected 2x per year. One hunderd percent of Madison County high risk food ser-

vice establishments received at least 1 inspection. Ninety-two percent of high risk food service establishments

received a second inspection.

ENVIRONMENTAL HEALTH INSPECTIONS/PERMITS/ACTIVITIES

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2012 HEALTH PROMOTION HIGHLIGHTS

The department partnered with the Madison County Sheriff’s Office, Canastota Police Department, and Safe Kids Upstate NY to offer a bike helmet giveaway at Zem’s Ice Cream & Mini Golf in Canastota in May. Safe Kids Upstate NY provided $500 in funding, which purchased the 65 helmets distributed to children.

The department, in partnership with the Madison County Sheriff’s Office and the NYS Police, sponsored four car seat checks held in Canastota, Hamilton, Morrisville and Oneida. Certified car seat technicians checked 79 seats and replaced 19 unsafe seats.

The department, as part of the Madison County Living Well Partnership, helped to sponsor “A Good Night’s Sleep: Helping Parents & Children Develop Healthy Sleep Practices” in August. Forty-nine people who work directly with families with young children attended this workshop and learned how insufficient sleep is linked to obesity and how to help parents create routines and healthy sleep habits for their children.

The department, as part of the Madison County Living Well Partnership, helped to sponsor the 10th Annual Eat Well Play Hard Family Fun Day, which drew 620 people to Allen Park in Oneida in August. The event received a $750 pri-vate donation, which funded the port-a-john & handwashing station, two interactive activities, and supported the live radio broadcast from Mix 106. UnitedHealthcare Community Plan once again provided $500 to fund 100 bags of fresh produce from Stone Brothers Farm stand. New this year, Chobani donated 36 cases of Greek yogurt.

Health Department staff served as part of the planning committee for the Shades of Green Workshop, the very first green workshop of its kind in the County in February. Along with members of the Planning Department, represent-atives of Upstate Regional Planning Commission, Cazenovia College and others brought National and State speak-ers and experts on living green to over 300 participants from in and out of the Central New York area.

PROGRAM AREAS Healthy Environments

Healthy Behaviors (nutrition, physical fitness, immunizations, personal hygiene)

Public Health Preparedness

Health Care Information

Injury Prevention

Mission Using evidence-based research and practices, the Health Promotion Division designs and develops strategies to communicate accurate health information and deliver quality programming for residents to increase knowledge

and skills and to positively influence policy and practices, improving health and quality of life.

Vision The Health Promotion Division strives to engage the community in order to positively impact the health decisions

and the environments of individuals, families, and communities.

The Health Promotion Division is a multidisciplinary area of public health practice that draws on the social and behav-ioral sciences and from the scientific fields of health promotion, social marketing, and health and risk communication. The Division is focused on creating, communicating, and delivering health information and interventions that are es-sential to meeting health information needs of our communities. We apply traditional marketing theories and princi-ples and add science-based strategies from prevention, health promotion and health protection to guide work in pub-lic health research, interventions, preparedness, and education and communication campaigns.

Car Seat Checks

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Educational packets including information on ticks, mosquitoes and repellents along with rabies and post-exposure prophylaxis were created and distributed to libraries across the County. Additional information specific to physi-cians and healthcare workers was also distributed on the same topics.

A Six Steps to Better Balance Workshop for residents was held during Falls Prevention Awareness month in Septem-ber. The Workshop, organized by the Falls Prevention Committee of the Madison County Living Well Partnership, brought in nationally renowned expert on fall prevention, Betty Perkins-Carpenter, author of the book “How to Prevent Falls”. Participants learned how to reduce the fear of falling and practiced ways to reduce the probability of falls and fall-related injuries, increase flexibility, energy and overall endurance.

The Walkability Report for the City of Oneida was released in April 2012. The report considers how walkability, a smart growth principle, can be leveraged to improve health while achieving the City’s vision for the future. The re-port provides practical suggestions and strategies for rural areas to consider when framing future changes and zon-ing ordinances. The report is available at http://bit.ly/ZkQl6s.

Health Literacy on the Internet – the Health Department partnered with RSVP to present to Head Start staff on the importance of Health Literacy and provide a deeper understanding of how to share health literacy information with parents and others. The presentation included how to effectively use the Internet to find reliable health infor-mation. Participants received a CD-ROM of Health Information to share with parents as well as a list of trustworthy web sites.

Conducted Farmworker Health Outreach to area farms offering free immunizations and health information pack-ets.

Provided information on Immunization and disease to all school nurses via CDROM. Information included: Com-municable Disease Reporting Requirements, Flu, Measles, Pertussis, Immunization Schedules, Exemptions from Immunization Requirements, Recommended Immunizations for College Entrance 2012, Vaccinations in Refugee

Flu Point of Dispensing (POD) Exercise

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2012 PREVENTIVE HEALTH HIGHLIGHTS

Disease Specialist was hired to coordinate and review reported diseases and illnesses with the goal of prevent ill-ness and disease in the residents of Madison County.

Provided flu vaccinations and Zostavax immunizations clinics to the Madison County community.

Coordinated POD drill to provide flu vaccine to County employees, Health Department staff, police, fire, EMS, Day-care staff, Head Start, WIC and Community Action Program.

Approved as a Licensed Home Care Agency on March 15, 2012 to provide Maternal Child Health visits and a Diag-nostic and Treatment Center to administer vaccines — admitted 54% of referrals.

Collaborated with community based partners to establish the Breastfeeding Connections Café twice a month as a networking and support system for breastfeeding mothers.

PROGRAM AREAS

Disease Control and Prevention

Communicable Disease Investigations

Immunizations

Sexually Transmitted Infections Referrals for Screening and Treatment

Tuberculosis Screening and Prevention

Maternal and Child Health

Lead Poisoning Prevention

Maternal and Child Health Home Nursing Visitations

Mission The Preventive Health division provides education, programs and services necessary to promote health in the

community.

Vision It is with pride that we take responsibility for providing programs and services that help reduce disease, educate and support children and their families and promote health in the community with integrity and compassion. By

partnering with businesses, non profit organizations, schools and healthcare professionals, we will strive to empower individuals to make healthy choices to improve their quality of life.

The Prevent Division programs focus on prevention and health maintenance. Programming is designed to promote the highest level of health through outreach, health guidance, outreach, prevention of illness and injury, disease surveil-lance, and care planning and coordination.

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DISEASE 2012 2011 2010 2009 2008

HIV/AIDS

Not

released by

NYSDOH

Not

released by

NYSDOH

Not

released by

NYSDOH

Not re-

leased by

NYSDOH

Not re-

leased by

NYSDOH

CAMPYLO BACTERIOSIS 13 12 16 14 8

CHLAMYDIA 152 131 122 113 132

CRYPTO SPORIDIOSIS 16 7 12 10 15

STEC, non E-COLI 0:157 1 1 2 1 4

ENCEPHALITIS 0 0 0 0 1

HEP A 0 0 0 1 0

HEP B (ADULT) 0 1 chronic 0 chronic 5 chronic 0

HEP C 1 acute

18 chronic

2 acute

11 chronic

0 acute

17 chronic 28 chronic 11 chronic

GIARDIASIS 1 10 10 9 19

GONORRHEA 6 10 6 7 6

Haemophilus influenza, non type b 1 1 1 0 2

LISTERIOSIS, 1 1 1 0 0

LYME DISEASE 5 13 8 21 6

MALARIA 0 0 0 0 0

MENINGITIS - ASEPTIC 3 0 0 1 0

- BACTERIAL 0 0 0 1 0

PERTUSSIS 35 6 15 1 3

Q FEVER 1 1 0 0 0

STREP GRP A, invasive 3 6 2 1 3

STREP PNEUMONIA 4 8 7 17 11

SALMONELLA 8 7 14 4 13

SHIGELLOSIS 1 0 3 0 0

STREP GROUP B, invasive 8 6 5 6 6

SYPHILIS 0 0 0 0 1

TUBERCULOSIS 1 0 0 1 0

YERSINIOSIS 0 0 0 1 0

LEGIONELLOSIS 0 0 1 3 1

INFLUENZA A lab confirmed 255 48 4 178 81

INFLUENZA B lab confirmed 6 32 0 36 21

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BOARD OF HEALTH John Endres, President

John Salka, Vice President

Margaret S. Argentine

Samuel Barr

Wendy Cary

Robert Delorme

Rachel Elder

Jennifer Meyers

PUBLIC HEALTH COMMITTEE John Salka, Chair

Roger Bradstreet

Lewis Carinci

James Goldstein

Alexander Stepanski

MEDICAL CONSULTANT R. Seelan Newton

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Public health encompasses three core functions: assessment of information on the health of the

community, comprehensive public health policy development and advocacy for best management

practices, and assurance that public health services are provided to the community. These functions

have been defined further and expanded into 10 essential public health services.

Monitor health status to identify and solve community health problems

Diagnose and investigate health problems and health hazards in the community

Inform, educate, and empower people about health issues

Mobilize community partnerships and action to identify and solve health problems

Develop policies and plans that support individual and community health efforts

Enforce laws and regulations that protect health and ensure safety

Link people to needed personal health services and assure the provision of health care when oth-

erwise unavailable

Assure a competent public and personal health care workforce

Evaluate effectiveness, accessibility, and quality of personal and population-based health services

Research for new insights and innovative solutions to health problems

Effectively provided, these services will reduce the substantial burden of preventable illness and in-

jury. Further, costly medical services needed to treat preventable conditions are avoided. Preven-

tion is not only cost-effective; it is fundamental to assuring quality of life for all Madison County resi-

dents. While no definition of public health’s essential role in our county’s health system will ever be

final, this statement of essential services is used as a tool for moving forward with greater clarity of

purpose in a time of challenging changes.

1 Institute of Medicine, Committee for the Study of the Future of Public Health. The Future of Public Health. Washington,

DC: National Academy Press, 1988.

2 Harrell, J.A., and Baker, E.L. The essential services of public health. Leadership in Public Health 3(3):27-31, 1994.

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Department of Health Madison County

www.healthymadisoncounty.org © 2012 PO Box 605 · Wampsville, NY 13163 315-366-2361 · Fax 305-366-2697