Cumberland County HealtH department 309 buCk St.

millville, nJ 08332 856-327-7602 www.CCdoH.org

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Index

Department Mission and Vision Statements 3 Board of Health 4 Letter from the Health Officer 5 Department Services 6-7 Environmental 8 Public Health Nursing 9-13 Special Child Health Services 14-15 Health Education/Community Services 16-19 2015 Sources of Revenue 20 2015 Budget 21 Website & Social Media 22

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Cumberland County Health Department

Our Mission The Cumberland County Health Department is dedicated to the promotion,

protection, and improvement of the public’s health in partnership with the communities that we serve.

Our Vision Healthy Lifestyles, Healthy Communities

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Cumberland County Board of Health

2015 Members

Paula Ring, Chairperson

Ernie Zirkle, Vice Chairperson

Carol Musso, Freeholder

Darlene Barber, Freeholder Alternate

Charlotta Birdsall

Kim McKown-Strait

Eileen McMahan

Joy Wood

Steve Errickson, Board Secretary

Steven Rothman, Esq., Board Solicitor

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Cumberland County Department of Health

309 Buck Street Millville, NJ 08332

(856) 327-7602 www.ccdoh.org

To The Residents of Cumberland County:

I am pleased to provide you Cumberland County Health Department’s 2015 Annual Report. The Cumberland County Health Department provides services to 13 municipalities in Cumberland County and continues to strive to ensure we achieve our mission of being dedicated to the promotion, protection, and improvement of the public’s health in partnership with the communities that we serve. For 2015, we continued on our path of educating residents, servicing our clients, and promoting public health in all that we do. Our Environmental Health Division continued with their education efforts by hosting a Body Art presentation in collaboration with a local licensed body art business. The Division also hosted a meeting and presentation for professionals who work in the septic system industry. The presentation included updated information on regulations, internal processes, and a question and answer period. The Nursing Division started off the year with our first individual that needed to be monitored for Ebola and ended the year with a total of 6 individuals that had traveled to affected countries and needed to be monitored. Monitoring of individuals consisted of contacting them once a day for 21 days and recording their temperatures. We also spoke with them daily to ensure they felt fine and did not pose a risk at any time of being infected with Ebola. Our Special Child Health Services Division assisted with the planning of the first ever Cumberland County Out of the Darkness Suicide Prevention and Awareness Walk. The Health Education/Community Services Division held a Potassium Iodide (KI) distribution for those residents within a 10 mile radius of the nuclear power plant. We had a successful turnout with providing 505 KI pills to residents. The Health Department is also proud we were able to reduce our budge from the 2014 budget year. We strive to keep costs down and do our due diligence with only expending when necessary. The Cumberland County Health Department continues to provide exceptional public health services to our communities and strives to always maintain a professional and courteous approach in everything we do. Although our tasks are not always easy, we ensure we carry our organizational values, as well as our mission and vision, with us in all endeavors and initiatives we engage in. I would also like to show appreciation to our Board of Health, our Community Health Advisory Board, the County of Cumberland, and all of the organizations that support and collaborate with us to ensure we have the resources and tools we need to provide all 10 essential public health services, as well as much, much more services to our communities. We look forward to providing another year of service in Cumberland County and to strengthening our relationship with our residents and community partners.

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Cumberland County Health Department Services:

Environmental Health Services – Noah Hetzell, Environmental Coordinator • Hazardous materials incidents, clean-up monitoring and emergency response

• Air Pollution Control Inspections and enforcement for dry cleaners, paint spray booths, boilers, generators, bulk fuel storage tanks, citizen complaints on odors, open burning, and idling.

• Lake and surface water monitoring and water pollution enforcement

• Illegal dumping investigation

• Healthy Homes education and outreach

• Public Health Complaint investigations

• Rabies and Zoonosis Control – animal bite investigations, rabies clinics, pet shop and kennel inspections, West Nile Virus crow surveillance

• Noise Pollution investigation and enforcement

• Inspections on the following: o Landfill, Convenience Center, Compost and Recycling Centers o Childhood lead surveillance, abatement and enforcement o Right to Know survey, assistance and information o Public non-community water supply systems o Recreational Bathing – pools, spas, lakes o Septic System permits and installations o School Integrated Pest Management o Municipal water cross connections o Campgrounds and Youth Camps o Well construction and permits o Tattoo and Body Art Facilities o Retail Food Establishments o Recycling and Enforcement o Pesticide Applicators o Tanning Facilities

Nursing Services – Elaine Webster, Interim Director of Nursing • Shots for Tots: Free immunizations for uninsured or under-insured children ages 2months-18years

• Childhood Lead Poisoning Prevention Program

• Sexually Transmitted Diseases

• HIV Testing

• Diabetes Screening Information

• Hypertension (blood Pressure) Screenings, with chronic disease education and information

• Influenza Immunizations

• Tuberculosis Program

• PPD Testing

• Adult Immunizations including Pneumonia, Shingles, HPV, Hepatitis B, and Tdap

• Communicable Disease Program

• School Immunization Audits

• Improved Pregnancy Outcomes

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Special Child Health Services – Elizabeth Thomas, Coordinator Special Child Health Assists in providing coordinated services to children from birth through age 21 with chronic health condition, disabilities and developmental delays

• Informal counseling and referral

• Assessment of family and child needs

• Assistance with health and educational services

• Crisis Management

• Case Management and Monitoring Assists in acquiring the following:

• Early Intervention Services

• Supplemental Security Income (SSI)

• Model Waivers for medically fragile children

• Catastrophic Illness in Children Relief Fund (CICRF)

• Pharmaceutical assistance for Children with lung conditions

• Hearing aids and prostheses

Health Education / Community Services – Tejlah Cooper, Director of Health Education Hosts free educational presentations

• Cardiovascular Education and Prevention

• Cancer Education and Prevention

• STD Prevention Education

• HIV/AIDS Awareness Education

• Serves as an informational resource for community organizations

• Contribute to the health of the population through assessment, research, and evaluation activities Provides residents with resources, information, and support with medical, dental, and social programs.

• Limited prescription assistance for indigent populations

• Medication assistance for seniors and disabled

• Children’s dental services Responsible for planning, distribution of information, epidemiological investigation and education before, during and after public health emergencies and threats.

• Increase local preparedness for all hazards in the county

• Manages a county wide email and fax alert system – Local Information Network Communication System (LINCS)

• Manages the Medical Reserve Corps (MRC) which is a group of health professional and community volunteers that can assist in emergencies as well as every day public health initiatives.

Information Technology – Kevin Mason, Network Administrator 1 Responsible for designing, installing, administering, and management of all information technology resources including but not limited to LANs, WANs, Internet Systems, and End user Support.

Finance – Debra Petersen, Supervisor of Accounts Responsible for payroll, accounting, and all functions of the department’s finances.

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2015 Environmental Division

Highlights

The Cumberland County Health Department Environmental Division performs activities and services in more than twenty-two programs. In 2015 over 6737 routine activities, including permit approvals, certifications, inspections, complaint investigations and other service requests were performed. In addition, staff followed up on over 221 animal bite reports and provided valuable education and information concerning Rabies, a deadly communicable disease. Rabies vaccinations were provided to over 1680 dogs and cats at 6 Environmental Division sponsored clinics.

Other Environmental Division highlights include:

• Continued Outreach with the Bayshore Community Partners including owners, municipal & state officials & professionals within the sewage & well industries

• Performed Healthy Homes Community & Workers Presentations & Outreach at Drug Court, local housing complexes, daycares & child family centers, local zoo, library & organizations

• Hosted 1 Environmental Program and 1 UMDNJ medical interns

• Created Educational Handouts and documents including Healthy Homes Booklets • Provided an Educational Presentation for Body Art

• Presented Multiple Septic System Outreach Programs within various municipalities to colleagues & various community groups including realtors, residents, contractors, inspectors, engineers & non-profit environmental groups

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• Presented at Cohansey Area Watershed Association (CAWA) on surface water contamination

• Assisted with Community Development Grant Applications • Participated in Awareness Campaigns including Bubbles for Autism, March of Dimes, Heart

Association • Continued Collaboration with the Southern Regional Mobile Food Vendor Task Force

• Assisted the Nursing Division with the operations of the County Health Dept Annual Flu Clinics • Provided continuous Compliance Assistance within the regulated community for multiple facilities,

business owners, professionals & individuals within the general public involved in air permitting, food service, safe drinking water compliance, contaminated sites, septic, recycling, lead remediation

• Staff Membership in Many Community Organizations and Associations – keeping involved in the promotion of Healthy Communities through partnerships within the community including, Cohansey Area Watershed Association, Rotary, Soroptomist, Hopewell Environmental Commission, The New Jersey Delaware Bayshore Council & Long-term Recovery Infrastructure Subcommittee, and New Jersey Emergency Preparedness Conference Committee

• Attended numerous meetings at Departmental, Local, County & State levels for continuous collaboration.

• Assurance to Provide a Trained and Competent Workforce - To better serve our community, staff attended many up to date program training and certification courses.

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2015 Public Health Nursing Division Highlights

The Cumberland County Department of Health Nursing Division has continued to provide quality

health services the past year. The year has been full of both opportunities and challenges as staff have taken on new and ever-evolving job duties. The nursing staff continues to strive to provide the best possible services to those in our community.

We recognize providing these services must be through diligent collaboration with community partners to ensure these services are within reach of our entire community. Thus, we not only concentrate our focus and efforts on internal strategies but remain intentional with engaging community partners.

We exist to improve health care quality and delivery, to influence policy, and to provide information that promotes health, prevents disease, and empowers people to make sound health choices. This report services to highlight ways in which the nursing division has made a difference. As we move forward, the nursing division will continue to monitor the ever changing needs of our population, and we will continue to provide the preventative health services that we need to grow stronger and healthier communities.

Core Programs:

• Seasonal Influenza Program

o As of December 31, Public Health Nursing administered 1,168 doses of Influenza vaccine to our residents. Clinics were offered at sites throughout the county with an emphasis on providing opportunities for the highest risk populations and the uninsured to receive immunization.

o Influenza Vaccines were also administered at our annual drive-thru flu clinic which serves as a mass dispensing exercise.

o Flu shots were offered free for no insurance and under-insured residents and for residents with an insurance provider, the health department billed the insurance provider; however, offered with no co-pay for residents.

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• Childhood Vaccine Program (VFC)

o The public health nurses fulfilled the requirements to re-enroll in the Vaccine for Children Program.

o Public Health Nursing offers twice monthly immunizations clinics in Bridgeton and Millville for uninsured and underinsured children. The program services primarily to undocumented children who may not meet the criteria for Medicaid and children whose insurance has lapsed in the interim reinstatement period. Vaccine is provided at no cost to the Health Department through the federally funded Vaccines for Children Program. Additional “Back to School” clinics were offered in January, August, and December 2015 to facilitate the high demand for children delinquent in required immunizations to enter school and avoid exclusion. Program staff also serves as a resource for school nurses to interpret state regulations, exclusion criteria, and interpretation of international immunization records.

o In collaboration between public health nursing, Millville School District, and lead school

nurse of Millville School District, services to expand HPV immunization rates continue conducting a monthly clinic at Lakeside Middle School. This pilot program is the first school based Human Papillomavirus vaccination clinic in the state of New Jersey and demonstrates the commitment of the partnering entities in promoting both access to vaccination and vaccination compliance; an important public health objective. This program provides evidence based strategies to increase HPV immunization rates among young adolescent girls and boys. HPV vaccination is administered to both private and VFC eligible children following Advisory Committee Immunization Practices (ACIP).

o The VFC nurse coordinator along with the lead school nurse in Millville School District presented the HPV pilot program to professional colleagues at the Annual NJ Vaccine for Children Conference.

o The public health nurses also provide childhood immunizations during the summer months (July- September) at Pathstone Child and Family Development Migrant Day Care Program.

• Adult Immunization Program

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o The public health nurses fulfilled the requirements to re-enroll in the Vaccine for Children Adult Program.

o Public Health Nursing also offers no cost immunizations to uninsured adults ages 19 and older. Vaccine is provided at no cost to the Health Department through the federally funded Vaccines for Children Program. Adult immunizations are offered at our weekly STI Clinic and at roving sites throughout the county.

• School and Child Care Audits

o State mandated immunization audits were completed for all child care, preschool, kindergarten, and sixth grade students in the County. The public health nurses also provide training in relevant areas including utilization of the New Jersey Immunization Registry and how to use the Centers for Disease Control (CDC) website to provide educational materials and resources.

o Program staff has developed a strong collaboration with association members and present trainings at the Cumberland County School Nurses Association on updates to immunization requirements and school audits.

o Nurse coordinator created an email distribution list to all school nurses, preschools and day care facilities to provide educational material and resources on immunizations and immunization audits, flu clinics, and disease outbreaks.

o In addition, the VFC nurse coordinator for completion of Capstone Project in RN-BSN program developed an evidence-based project on Immunization Requirements Auditing preschools, day cares, ad child care centers and implemented for on-site preschool, day care, and child care center staff responsible for audits.

• Communicable Disease Program

o There are many challenges of infectious diseases that face community health nurses, public

health nurses follow all primary, secondary, and tertiary levels of prevention during investigation of all 73 reportable diseases as set forth by N.J.A.C. 8:57.

o In addition to the reportable investigations, public health nurses conduct education and outreach and attend required trainings for communicable disease.

o During the emergence of Ebola Virus Disease, the communicable disease nurses met routinely to review protocols and procedures for emergency preparedness.

o The public health nurses also work closely with the New Jersey Department of Health (NJDOH) Infectious and Zoonotic Disease Program or guidance and consultation in investigating disease outbreaks, technical information, and obtaining educational material on communicable diseases.

• HIV Testing

o Public health nurses provide weekly HIV testing and counseling at the STI clinic, and

monthly at the school based STI clinic. o Through the support of the New Jersey Department of Health HIV Division,

a mobile HIV testing van was acquired at no cost to the Health Department. This mobile unit enables program staff to reach out to the at risk population for testing, early identification, and early entry into care during outreach events for targeted population based screening.

o Through the Division of NJ DOH STD/TB/HIV services additional funding was received to increase HIV screening rates for at risk populations, this requires extensive program services and evaluation.

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o HIV nurse coordinator also hosts the monthly Southern New Jersey HIV Collaborative meetings at the Health Department. This very active and effective group brings together community partners for collaboration and problem solving.

• Tuberculosis Control Program (TB)

o The tuberculosis program in collaboration with Inspira Health Network, Vineland and an individual contract with a private MD continue to provide medical services for the care and follow up of persons with active TB and Latent TB infection. Clinic services are provided on a monthly basis until the completion of therapy.

o In addition to the monthly chest clinic, public health nurses arrange for monthly medical follow up for children at the TB Specialty Clinic at Cooper. The TB coordinator arranges appointments, transportation, and attends appointment with patients for coordination of case management, services, and treatment.

o TB coordinator and public health nurses oversee and enforce program guidelines that include extensive case management, daily direct observation therapy, and investigations of active and non-active disease and contacts through referrals obtained through, but not limited to, hospitals, primary care physicians, and referrals from other jurisdictions. The program has seen an increase in case load over the past few years due to an increase in people identified with LTBI and accepting treatments.

o The public health nurses also offer PPD testing by appointment only. o In efforts to allow flexibility of the public health nurses and convenience for the patients,

the public health nurses with the support of the health officer and information technology (IT) will be piloting the use of Video Direct Observation Therapy (VDOT) as an alternative to direct observation therapy for eligible patients for efficient TB control. The health officer, IT, and public health nurses researched existing policies, procedures, equipment, and established a cost analysis. The equipment was purchased and the public health nurses are finalizing policies and procedures to set up initial training.

• Sexually Transmitted Infection Clinic (STI)

o The public health nurses in collaboration with FamCare (rented facility space) and an individual contract with private MD continue to provide weekly STI clinics for STI testing and treatment.

o Through collaboration with the Millville School District and Millville High School Student Support LINK program nurse practitioner, the public health nurses and staff continue to provide a monthly STI clinic held at the Millville High School. In FY 2016, an additional clinic will be scheduled to capture the increasing student interest.

o The public health nurses also through additional funding by the NJDOH will be providing additional STI testing and counseling at roving targeted sites and health fairs throughout the county to increase screening rates and awareness of STI’s for our vulnerable populations.

• Chronic Disease

o In collaboration with the Health Education and Community Services Division, Public

Health Nursing participated in Health Fairs and other community outreach events. Public health nursing and MRC nurses perform monthly BP screenings and glucose monitoring screenings held at nutrition sites, STI clinic, and at the county college.

• Childhood Lead Poisoning Prevention (CLPP)

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o As per N.J.A.C. 8:51 the public health nursing division has received partial funding by the

NJ DOH to continue to provide case management to lead burdened children in Cumberland County including the city of Vineland. This program requires comprehensive case management including home visits, nutrition and health education, medical monitoring, social service collaboration, and extensive documentation.

o The partial funding also assists with point of care blood lead testing; free blood lead testing for children 1-6 years of age and pregnant women regardless of insurance. The public health nurses offer blood lead testing at day cares, schools, and other outreach events in targeted areas.

o The CLPP program staff also is involved in several coalitions as collaboration in efforts to reduce blood lead poisoning and increase screening rates.

• Healthy Homes

o The healthy homes certified inspector and public health nurses provide outreach initiatives

on a wide range of environmental expertise in health issues related to mold, secondhand smoke, toxic fumes, and lead dust.

o The specific program goals include enhancing partnerships with community based organizations, schools, property owners, tenants, remodelers, renovators, maintenance workers, lead based paint contractors, and construction office staff.

o The healthy homes inspector also promotes and conducts trainings to create awareness to increase blood lead screenings, provide lead safe work practices, and develop programs to address the overall safety of housing.

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• Superstorm Sandy Block Grant (SSBG)

o The NJ Department of Health was awarded funding to help New Jersey residents prevent and mitigate post-storm environmental health issues due to Superstorm Sandy; working with health care and public health partners, the Department implemented programs to educate the public and conduct surveillance of health hazards in homes such as mold and lead.

o The public health nursing division was awarded funding to increase access to blood lead screenings in Cape May. For FY 2015, public health nurses performed targeted blood lead screenings in Cape May County, one of the nine affected counties from Superstorm Sandy.

o Targeted blood lead screenings and outreach emphasized the prevention, control, and elimination of lead exposures rather than responding after the exposure. Children, pregnant women, and others identified as at risk to lead exposure were targeted for blood lead testing activities.

• Improving Pregnancy Outcomes (IPO)

o The primary activity of the grant is outreach and activity at a grass roots level conducted by Community Health Workers.

o Community Health Workers, Social Worker, and public health nurse perform door to door outreach targeting women and men of childbearing age assisting with education, guidance, and support in efforts to increase access to prenatal care and identifying other prioritized needs and linkage and referrals to other community resources.

o The program also conducts training on, but not limited to, nutrition, immunizations, pre- and postnatal care, parenting, birth control, safe sex, writing resumes, and how to promote a positive image during a job interview.

o The successful achievements of IPO program are staff who implemented creative strategies focusing on outreach and engaging high need women and their families and identification of needs and risk factors.

Trainings

o To better serve our community, staff attended and completed trainings and certification programs.

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2015 Special Child Health Services Division Highlights

Annual SCHS Statistics:

5,240 Contacts on behalf of Children

513 New Referrals or Re-Opened Charts

480 Closed Charts

405 Average Quarterly Active Caseload

Received the following donations for families:

• Completed Toys for Tots applications for 3 families. • Donations, excluding Catastrophic Illness in Children Relief Fund, total $7,988 dollars. Some

examples of 2015 assistance include the following: o Ramp installation o Medical Stroller purchase o Waived guardianship fees o Clothing

• Completed the Case Manager’s Activity Sheet for 4 Catastrophic Illness in Children Relief Fund applications. Received Catastrophic Illness in Children Relief Fund awards totaling $3,773.40.

Awards/Recognition:

• Tina, Susan, and Beth completed the A Partnership for Change Intimate Partner Violence Advocate Certificate Program.

• Susan and Beth completed CPR/AED Certificate Program. • Beth completed Dr. Macy training on Post Traumatic Stress Disorder and Psychological First Aid. • Susan and Beth completed Mental Health First Aid Certificate Program.

Charity Support:

• Collected $226.00 from Cumberland County employees for March of Dimes from November 2014 to April 2015.

Participation: • Collaborated with Cumberland County Surrogate’s Office regarding 5 Guardianship applications

for adult children. • Participated on Robin’s Nest Healthy Families Advisory Board. • Participated on Cumberland County Human Services Advisory Council.

o Participated on the RFP Planning Committee. • Participated on Cumberland County Disabled Advisory Council Children with Disabilities Sub-

Committee. • Participated on Cumberland County Mental Health and Addictions Board.

o Participated on the RFP Review Committee. o Participated on the Planning Committee. o Participated on County Alliance Steering Sub-Committee

• Participated on Cumberland County Council for Young Children o Co-Chair of Health Committee

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• Participated on the Cumberland County Traumatic Loss Coalition o Attended Cumberland County Freeholder meeting for Recognition of Suicide Prevention

Month and role of TLC o Planning Committee for the 1st Annual Cumberland County Out of the Darkness Suicide

Prevention and Awareness Walk. • Participated on the Cumberland County Long Term Recovery Group. • Participated on the Cumberland Inter-Agency Coordinating Council (CIACC) • Participated on SCRATCH Out Substance Abuse (Salem Cumberland Regional Action toward

Community Health) Coalition. o Vice-Chair of Coalition o Met with State Representatives about Substance Abuse and Prevention o Attended Governor’s Facing Addictions Task Force

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2015 Health Education / Community Services Division Highlights

Health Education

1) Health Education Division staff was successful in completing 8 community education presentations that covered a variety of topics such as: chronic diseases, communicable diseases, head lice, and antibiotic resistance.

2) Health Education Division participated in the Out of the Darkness Suicide Prevention Walk at the Cumberland County Fairgrounds which raised over $16,000 and saw over 330 participants join.

3) Health Education Division Staff participated in 22 health & wellness fairs throughout Cumberland County and were able to provide outreach education to over 1,000 community residents.

4) Health Education Division Staff were able to continue to assist with 3 Millville corner stores and 3 Bridgeton corner stores for the Healthy Corner Store Network in a partnership with the Cumberland Cape Atlantic YMCA and Vineland Health Department.

5) Health Education Division participated in the 2015 Joint Information System/Public Information Exercise provided by NJDOH for the purpose of testing our Risk Communication Plan.

6) Health Education Division staff also sits on the Cumberland County Healthy Communities Coalition; a group that was formed to build healthy communities by reducing substance abuse among youth, focusing on preventing underage drinking, marijuana use, and prescription drug abuse.

7) Health Education Division Staff were successful in getting 4 press releases published via various media channels.

8) Health Education Division Staff were invited to attend the WMIZ Radio program on station 1270 AM to talk about Health Department activities and programs.

Emergency Preparedness Preparedness Activities

1) Health dept. staff participated in a Regional Medical Counter Measures Exercise along with Cape May and Atlantic Counties

2) 10 health department staff attended the NJ Emergency Preparedness Conference. 3) Health dept. staff participated in three CDC drills including: Staff Notification, Facility Set-up, and

Site Activation 4) Preparedness Division staff participated in a Risk Communication Tabletop. 5) Preparedness staff participated in a Joint Information Center exercise in order to test our Risk

Communication plan. 6) Through the Local Information Network Communication System (LINCS) we were able to send

out 168 messages to staff and local partners. 7) Preparedness staff participated in a LINCS agency Notification Drill to test various communication

channels. 8) Preparedness staff participated in monthly testing of the Hippocrates system. 9) Health dept. staff participated and responded to 4 call down drills.

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Medical Reserve Corps (MRC)

Cumberland County Health Department expanded its MRC program by enrolling four new volunteers. Throughout the year, some of the MRC volunteers activities included:

• Attending 60 community health events and providing chronic disease education. (flu clinics, health fairs, etc.)

• Screening 113 residents for high blood pressure as well as providing education. • Participating in a Mental Health & First Aid training. • Attending the New Jersey Emergency Preparedness Conference.

The Health Department also received an award of $3,500.00 through the National Association of County and City Health Officials (NACCHO). With this funding we were able to provide trainings, purchase medical and educational supplies as well as reimburse the nursing license renewal fee for nurses enrolled in the Core MRC Nursing Program.

Social Media/Outreach

• Through our Facebook site, the health department has reached over 355 ‘likes’ and our numbers continue to grow. This number is up from just 295 likes in 2014. During the year, over 250 social media messages were posted and shared. Several times during each month there are posts made highlighting National Health Observances, important health department events and/or updates, and our monthly newsletters. Some of our more popular posts included: o Cumberland County Job Opportunities – 2,100 people reached o KI Pill Distribution Event – 1,300 people reached o Flu Season Information (including flu clinic schedule) - 2,008 people reached o Rabies Information (including rabies clinic schedule) – 600 people reached o Staff News and Accomplishments – 1,772 people o Tattoo/ Body Art Modification Safety – 1,424 people

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In addition to our social media postings, the health department also distributes a monthly newsletter to staff as well as all County employees. These newsletters, which cover a variety of important health topics, reach over 600+ employees in addition to local businesses and municipal buildings. In 2015, our newsletter was distributed through our community e-mail distribution list which reaches over 85 people and also via Facebook where it reached over 950 individuals.

Community Services

• The prescription program was developed to add a “bridging” mechanism between immediate access and continuing future access to necessary medicines for Cumberland County residents in need. There is currently only one prescription assistance program, which targets the at risk population of the uninsured, excluding Vineland residents. Clients are given information and education on various drugs and reduced cost programs in order to continue access to medications. With the advent of the Wal-Mart, Shop-rite, and Target generic $4.00 drug cost programs, more clients are being referred directly to these programs. The second year of the Affordable Care Act has also assisted many clients normally seen under this program, reducing the program numbers.

o Utilizing 1 program for the year, Cumberland County Health Department assisted 134 County residents to obtain 432 prescriptions promoting health. With approval for New Jersey Medicaid taking 4-5 months currently, the wait is expected to generate clients for the program. While access to the Affordable Care Act website has increased, and additional counselors have been added to local healthcare agencies for application completions, according to the County Health Rankings and Roadmaps, 23% of Cumberland County residents remain uninsured with 6% of the county children still uninsured.

o The total pharmaceutical assistance amount of $ 27,333.19 was spent in 2015 from funds allocated to the budget from the County Health Tax. The Prescription Assistance program is divided into two parts: Medical assistance for ordinary pharmaceutical expenses and BOH+ for more expensive pharmaceuticals. These more expensive prescriptions are greater than the current limit per prescription/client and without the increased limit would remain outside the client’s ability to purchase.

o Since demographic collation of this program began, the average cost of prescriptions has grown from $33.41 in 2002 to $63.27 in 2015. What makes this increasingly significant is the fact that the number of clients has declined by 71% (from 456 clients in 2002 to 134 clients in 2015) and the average cost of prescription medicines has increased by 189%. With the state of the economy, Community Services has been assisting everyone with emergency prescription needs, as even clients with insurance (Medicaid, PAAD, ADDP) are unable to afford their multiple prescriptions and are requesting assistance with their co-pays.

• Gateway Community Action Partnership, which oversees the Children’s Mobile Dental program subsidized by the Cumberland County Health Department, utilizes the dentists at CompleteCare Health Network and increases the availability of specialized dental services for children and seniors. Gateway also utilizes UMDNJ funds for Headstart programs and Delta Dental for the Bright Smiles program.

o In 2015, under Dental services, the Toothmobile saw 120 visits by school children in Cumberland County. The program for Cumberland County School students underwent a total of 199 procedures. This program, under a new contract which began in September 2014, is currently reimbursing only for uninsured children due to Medicaid fraud law requirements.

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o In 2015, under Translation Services, Angel Morales made 1226 contacts for the Nursing, Special Child Health, Community Services and the Environmental divisions as compared to1541 contacts in 2014. These contacts consisted of telephone calls, home visits, office visits and letter translations. With the hiring of 3 additional bilingual personnel, it is interesting to note that the decrease in bilingual contacts to Community Services was only 20%. This brings up the concept of trust, an important concept for a public health department.

o While there are few programs involving the Vineland Spanish speaking population, it is important to note that 60.7% of all Translation Services occurred in Bridgeton. This is in line with the 2010 Census that reports an increase in the Mexican population in Cumberland County. This increase went from 5,165 in 2000 to 13,974 in 2010, a 270% population increase. As we enter the halfway mark for the next Census, those numbers can only increase.

• A project regarding prescription discount cards was assigned to Community Services for distribution by the County Administration. The Board of Chosen Freeholders is supporting a prescription discount card program, the ProAct card, which is designed to help consumers without prescription insurance cope with the high price of prescription drugs, by saving an average of 20% of the retail price of commonly prescribed drugs. Unlike the NACo discount card, Community Services is not mandated to monitor the program and therefore, there are no numbers to report on usage.

• Increased Knowledge of population needs through Demographic Data Collection The demographic information that is collected from the Prescription Assistance programs is subsequently examined for data trends. This data can also be examined to determine population service needs. The value of this data is in the “snapshot” picture that it takes of the aging, mental and chronic health problems of certain at-risk populations in the County and the impact that it has on public health. The information was derived from direct intake interviews with clients. In 2015, there was only a slight change from the 2014 numbers.

o 67% of those assisted were at or below the Federal Poverty Level, a targeted population in need of medical assistance programs. These clients will continue to be referred to CompleteCare Health Network, Charity Care at the local hospital; Inspira, and other local low-cost health care providers.

o 57.5% of those assisted were in minority groups that only actually comprise 48% of the County population. This suggests where human services support and recovery programs and health improvement programs need to be targeted.

o 57.4% of those assisted had serious chronic health conditions, such as asthma, diabetes, COPD,

cholesterol and high blood pressure, which required daily medications.

o 47.8% of the clients seen were unemployed. Cumberland County currently has a 12.2% unemployment rate as of December 2015.

o There was a slight decrease in the fact that 53.7% of those assisted in 2015 were in the 30-50 age

groups and in 2014, that percentage was 56%. This decrease may be attributed to the fact that the Chronic Health workshops sponsored by the State of New Jersey are reaching those at risk. However, it also show that the uninsured population, at an earlier age, is still encountering health problems, and is delaying medical intervention and treatment due to the lack of ability to pay. The financial burden of being unhealthy will become a future problem in the public health arena if health education and prevention needs are not increased to target these groups.

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o There was a shocking increase in the percentage of the technically homeless; 55.2% of the prescription assistance clients were technically homeless, having to depend on churches, organizations, family and friends for a place to sleep, according to the information that was received. This isn’t included in the HUD definition of homeless and suggests that there are more residents in this category than are currently known or being reported. This is in contrast with the 2011 figure of 29.2%. The Point in Time Homeless Survey, conducted by the State of New Jersey, limits itself to one day a year for data collection. That day is the last Wednesday of January, still in winter, that may not accurately depict the true homeless population. The 2015 Point in Time did not attract any large turnout due to the good weather.

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2015 Finance Division Highlights

2015 Sources of Revenue

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2015 Budget

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Website & Social Media

Visit us at www.ccdoh.org

“Like” the Cumberland County

Health Department on Facebook: www.facebook.com/CCDOH

Follow us on Twitter @CCDOH (CumberlandCoHealth)