The Faces of

Weber-Morgan Health Department2009 Annual Report

Prevention

Promoting Healthy Lifestyles

Protecting the Public’s Health

Providing Clinical Services

Preventing Environmental Hazards

The Faces of Prevention

Community Letter from the Director . . . . . . . . . 3

Influenza A (H1N1) Outbreak: Adaptability, Flexibility & Responsibility . . . . . 4

New WIC Food Packages . . . . . . . . . . . . . . . . . . 5

Investigating a Tuberculosis Cluster . . . . . . . . . 6

Monitoring Food Safety . . . . . . . . . . . . . . . . . . . 7

2009 Highlights… . . . . . . . . . . . . . . . . . . . . . . 7

Community-Based Abstinence . . . . . . . . . . . . . 8Education Program

Implementing a New Outdoor Smoking Regulation . . . . . . . . . . . . . . . . . . . . . 9

Addressing Air Quality . . . . . . . . . . . . . . . . . . . .10

Pool Safety Program . . . . . . . . . . . . . . . . . . . . .10

Budget & the Board of Health . . . . . . . . . . . . . . 11

We are pleased to share with you “The Faces of Prevention,” the 2009 Annual Report of the Weber-Morgan Health Department. Public Health exists to prevent the onset and spread of disease, and to minimize morbidity and death associated with illness and disease. This annual report highlights various ways in which public health operates to achieve these objectives.

Responding to the outbreak of an illness is one of the key mandates of public health. The year 2009 will forever be synonymous with the Novel H1N1 Influenza A disease outbreak. For a brief moment in time, the Weber-Morgan Health Department turned the bulk of its attention away from “normal” prevention activities and marshaled all of its resources to combat the spread of this pandemic influenza strain. For most staff members, this was their first exposure to a pandemic, and represented one of the most challenging and physically exhausting work experiences ever encountered. Time will slowly erode from our memory many of the significant details of the campaign, but those tender feelings of pride and accomplishment will remain forever etched in our thoughts and memories. We shall especially remember those valiant partnerships forged and the collective efforts by so many wonderful and dedicated people to protect the public against this deadly disease. It was truly amazing to witness the tireless efforts of countless individuals working together to combat this illness. I am convinced that individual efforts and community preparedness greatly contributed to the successful outcome of the flu campaign and to the health and safety of our residents. We express our deepest gratitude to all, especially the Weber-Morgan Board of Health for its encouragement and support throughout the year.

As you examine “The Faces of Prevention”, you will more fully understand the purpose and role of public health and appreciate the value of disease prevention efforts through our programs. The Weber-Morgan Health Department is committed to promoting and protecting the health and safety of our residents through a comprehensive array of preventive services. Our staff represents the very best in professional excellence, customer service and dedication to making the Weber-Morgan area a healthy and safe place to live.

Sincerely,

Gary M. House Health Officer/Director

Gary House, Health Officer, manning the long H1N1 vaccine lines.

Community Letter from the Director

477 23rd Street Ogden, UT 84401

236 E. Young Street Morgan, UT 84050

Administration (801) 399-7110

Auto Emissions Center (801) 399-7140

Birth & Death Records (801) 399-7130

Clinical Nursing Services (801) 399-7250

Environmental Health (801) 399-7160

Health Promotions (801) 399-7105

WIC (801) 399-7220

www.webermorganhealth.org

The mission of the Weber-Morgan Health

Department is to assess the needs of our community, enhance the quality of our environment, and

assure access to appropriate services delivered by a

professional staff dedicated to excellence.

Mission Statement

2009 Board of HealthKenneth Johnson, Chair Tina Kelley, Vice Chair Ken BischoffCraig Dearden Jan Zogmaister Frank Brown George Garwood Gary Harrop Ann LarsenDoug Stephens Marek Matyjasik

2009 Annual Report

Influenza A (H1N1) Outbreak:Adaptability, Flexibility & Responsibility

When a novel strain of flu spilled out of Mexico in the spring of 2009, we were prepared for a cataclysm. However, the H1N1 virus took a slightly different course than anticipated. It was highly contagious, but the toll it took was thankfully mild.

Using the Weber-Morgan Pandemic Influenza Preparedness Plan as guidance, we adapted our response efforts accordingly. In an attempt to slow the spread of the outbreak, we educated our communities in the practices of good personal hygiene, compulsory social distancing and early identification of cases. By late summer, the outbreak was spreading throughout our communities, and medical providers were experiencing a surge of worried patients with respiratory illness. Our public education campaign was in full swing emphasizing the message “wash your hands, cover your cough and stay home when

sick.” In the early fall, our days were filled with coordination meetings, developing community education materials and preparing a mass vaccination plan in anticipation of vaccine delivery. Our goal was to vaccinate the CDC’s priority groups using a combination of public health clinics and community partners as vaccinators. When the vaccine first arrived in small quantities, we opened our doors to the public. The demand was overwhelming, and the vaccine was gone in a matter of hours. Our initial efforts to deliver vaccine to providers taking care of at risk pregnant females, healthcare workers and children 6 months to 24 years were complicated by vaccines that were not suited for that purpose and quantities far smaller than the demand.

We adapted our plans to utilize a telephone-bank appointment system that effectively ended the long lines surrounding our building until the supply of vaccine increased. As larger shipments arrived, vaccine deliveries to our partner providers expanded. Our responsibility to move vaccine

out of our refrigerators and into people’s arms was achieved. We finished the year with a month-long mass clinic at the Weber County Fairgrounds, and when public demand diminished and vaccine supplies became adequate, WMHD quickly adopted an “open to everyone” strategy. This change was highly successful in our mass vaccination effort and was well received by the public.

4 Weber-Morgan Health Department

Providing Clinical Services

New WIC Food Packages

52009 Annual Report

The Women, Infants and Children (WIC) food package was revised in 2009 to address major health risks, such as obesity and poor nutrition, faced by WIC clients. This was the first major change in the food package in three decades. Previous food packages were designed to ensure participants’ diets were rich in essential protein, Vitamins A and C, calcium and iron but were not consistent with recommended dietary guidelines and did not address the special needs of diverse cultures. The challenge was to enact necessary changes to the food package without increasing the cost.

In response, the USDA and the Institute of Medicine approved the following criteria for the new WIC food packages:

• Reduce quantities of juice, milk, cheese and eggs in alignment with the 2005 Dietary Guidelines for Americans and recommendations of the American Academy of Pediatrics.

• Add fresh fruits and vegetables.

• Add whole grain foods and require breakfast cereal to contain at least 50% whole grains.

• Reduce milk fat provided to women and children 2 years of age. (Children between ages 1-2 will still receive whole milk).

• Substitute canned beans for dry beans for all children and women.

• Introduce age-specific infant formula, eliminate

infant juice, add baby food fruits and vegeta-bles and meat for fully breastfed infants.

• Provide food incentives for mothers to fully breastfeed

their children.

Clientele acceptance of the new food packages has

been very positive and the nutrition education messages

are reinforcing the benefits of these changes. An average of 7,472 clients

participated in our WIC program each quarter and we issued $3,837,829.63 in food vouchers for the year.

Investigating a Tuberculosis Cluster A nagging cough for over a year and no financial resources to get it checked out – these were the circumstances surrounding an extensive Tuberculosis (TB) investigation that occupied our communicable disease staff for much of 2009.

While treating a 6-year-old with active TB in February, our nurses began a series of interviews and tests that led to an undiagnosed adult relative, who was later determined to have over 50 close contacts who had been exposed to the disease. This individual, along with two additional toddlers were eventually diagnosed and treated for active pulmonary TB, a contagious form of the bacterial lung infection.

An additional 27 individuals were found to have latent TB. Sixteen completed the nine-month long treatment regimen. Another child, who had a genetically matched strain, was also diagnosed but was never directly associated with the larger caseload. We believe that investigations such as these illustrate the core services of public health and disease prevention in our community.

Diagnosed Reports of Family & Social Contacts of Active TB Case

6 Weber-Morgan Health Department

TB MeningitisChild

Initial Case02/05/09

AdultLTBI

AdultLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

Adultrefused

full exam

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’d

ChildLTBITx’dAdult

LTBITx’d

AdultLTBITx’d Adult

LTBITx’d

AdultLTBITx’d

AdultLTBITx’d

Adultrefused

full exam

Adultrefused

full exam

Adultrefused

full exam

Adultrefused

full exam

Adultrefused

full exam

Adultrefused

full exam

Adultrefused

full exam

Teenrefused

full exam Teenrefused

full exam

Teenrefused

full exam

Adultunable to evaluate

AdultLTBI

AdultLTBI

Adultrefused

full exam

AdultLTBI

AdultLTBI

AdultLTBI

AdultLTBI

AdultLTBI

TeenLTBI

TeenLTBI

Toddlerno

infection

Teenno

infectionToddlerrefused

full exam

Adultno

infection

Adultno

infection

Adultno

infection

Adultno

infection

Adultno

infection

Teenno

infection

AdultPrevious LTBI w/Tx

Pulmonary TBToddler

Third Case03/16/09

Pulmonary TBAdult

Second Case03/10/09

Pulmonary TBToddler

no known contact but genotype match

Fifth Case06/15/09

Pulmonary TBToddler

Fourth Case03/16/09(BRHD)

Active TB

Latent TB

No TB

53 people total 4 active TB – all treated + 1 separate 27 LTBI – 16 treated 8 no infection 14 refused testing/evaluation

Protecting the Public’s Health

Building for the Future – Planning and development of the new building access project started in February, with the contractor’s award signed in June. Working in conjunction with Weber County and the Weber-Morgan Health Department staff, the contractor finished the driveway, parking and landscaping in September. This completes the original building plan for the entrance off 23rd Street and leaves a sizeable construction pad for future expansion of the health department campus.

Planning for Emergency – In March 2009 a test of the emergency back-up generator was completed with assistance from department staff and outside vendors. The exercise was to test the response of the generator to provide electrical power throughout designated areas of the building when normal power was lost. The results indicated that many areas of the building worked well as planned but several key locations lacked power. The building has since been upgraded to ensure that all essential services will continue should generator power be necessary.

Sustaining the H1N1 Effort – During the H1N1 mass vaccination event, the administrative

staff kept busy offering purchasing, temporary staffing, billing and budgetary support to front line vaccination teams. We were responsible to manage registration and billing stations, provide food and water, coordinate and staff phone banks, and offer

general support throughout the entire flu campaign. As the vaccination effort

slowed, the administrative staff – joined by temporary hires – continued the task of

data entry for all records – a project that has continued well into 2010.

Expanding in Morgan – In 2009, the department continued to expand services in the Morgan County office. In February, both food handler cards and birth certificates were issued to Morgan residents once a month. This doubled the existing services provided in the past, joining nursing, immunizations and WIC. Business has increased significantly over the year, and we are thrilled to be offering expanded services.

72009 Annual Report

2009 Highlights

Monitoring Food SafetyMore than 200 known illnesses are transmitted through food, with symptoms ranging from mild to life-threatening. To prevent food-borne illnesses, Weber-Morgan Health Department inspectors conducted 1,180 compliance inspections at 749 food facilities, including 8 mobile carts. During those inspections, 1,286 critical and 1,281 noncritical violations were observed. Twenty six enforcement actions were initiated and four facilities closed. We also trained 7,249 food handlers in food safety.

Some important changes were made to the mobile cart regulation in 2009 to bring them more in line with restaurants. Cart operators are required to prepare their food in an approved commissary/servicing area and must return to that location for supplies, cleaning and other servicing activities. When not in operation, a mobile cart must be stored at an approved servicing area. In order to protect against health hazards, some menu items may be prohibited and food preparation steps may be limited. Additionally, customer seating is not allowed.

In 2009, the Health Department…Held 89,664 WIC counseling sessionsInspected 1,862 various Environmental Health sitesUtilized Over 200 individuals volunteer with H1N1 vaccination clinicsCompleted 658 Baby Your Baby visitsInformed 39,411 people about abstinence until marriageContacted 36,453 participants on smoking prevention

Spent 3,166 hours on emergency response and preparednessObserved 738 doses of TB medicationCertified 27,572 copies of birth and death recordsDispensed 39,083 doses of H1N1 vaccineReached 10,741 participants through injury prevention programsDistributed 375 Outdoor Parks No Smoking signs

Community-Based Abstinence Education Program As a result of three years of hard work and commitment, the Community-Based Abstinence Education (CBAE) Program has contributed to a 3% reduction in the birth rate among adolescent girls age 15-19 in the downtown Ogden area. While it may be difficult to relate this decrease directly to our programming, we can definitely show that our staff educators interacted in 2009 with more students than at any time in the previous years of the $3 million grant.

Known by its popular name in the schools and the media, the “Future Method” curriculum reached 5,000 students through in-school instruction, one-time school presentations and church youth groups. The program focuses on education of 12-18 year olds and also works with many community partner agencies to reach parents with a message about the ways and importance of talking to their kids about abstinence and early sexual activity.

In spite of the success being achieved through this federal grant, we recently received word that a funding change would reduce the 5-year grant to 4 years in favor of new teen-pregnancy prevention programs that require us to re-apply.

Promoting Healthy Lifestyles

8 Weber-Morgan Health Department

Students Reached by the Future Method Program

250 500 750 1000 1250 1500 1750 2000 2250 2500 2750 3000

Year 12007

Year 22008

Year 32009

1,125

1,577

2,594

92009 Annual Report

Implementing a New Outdoor Smoking RegulationOver 375 signs have been posted in parks throughout Weber and Morgan Counties reminding residents that smoking is prohibited in these public gathering places in accordance with Utah Law 26A-1-123. Most of the signs are red-and white notices posted around each park, but some communities held art contests for young people to draw their own signs.

On May 29, WMHD sponsored a “Come Play, Smoke-Free Today” event at Ogden City Municipal Gardens, coinciding with the day the new no-smoking in public places regulation went into effect. Festivities included free games, popcorn, snow cones and cotton candy. Prizes were given for correct answers in a Tobacco Facts and How-to-Quit trivia contest. Ogden City Mayor Matthew Godfrey invited school children to help him unveil the sign and a local radio station gave away tickets to see 3-11 and Ziggy Marley in concert. Nearly 1,000 residents attended.

Addressing Air Quality

Pool Safety Program

Weber County joined the rest of the Wasatch Front in exceeding federal air quality standards set by the Environmental Protection Agency.

The non-attainment designation came about because of stricter federal regulations and an increase in population in our community. Motor vehicles continued to be the major source of air pollutants. There are currently 152,500 vehicles within the county. The Weber-Morgan Health Department’s Inspections and Maintenance Program diligently works to minimize the amount of vehicle pollutants discharged.

In 2009, 142,357 vehicles were given emissions test. The test failure rate for the year was 7.9%, meaning 9,873 vehicles were in need of repair. These numbers are typically low in relation to the actual number of vehicles repaired for emission related items. Many vehicle owners initiate repairs prior to receiving an emissions test, so the actual numbers of polluting vehicles may be much higher.

The Virginia Graeme Baker Pool and Spa Safety Act took effect in 2009, requiring all public pools to replace drain covers to prevent swimmers from being entrapped or entangled under water.

Our Pool Safety Program worked with pool operators to ensure the new drains were correctly installed in all 168 public pools and spas in Weber and Morgan Counties. This was in addition to the regular training, water testing and enforcement actions that help promote safety and prevent illness each year. In 2009, our licensed environmental health scientists conducted 120 inspections and collected 954 pool samples. Six enforcement actions were initiated and three pools were closed. Thirty-seven Certified Pool Operators were trained in the proper operation of pools.

Weber-Morgan Health Department

Preventing Environmental Hazards

Budget

Revenue Local Taxes $1,421,788 22 .5%

State/Federal Contracts $2,875,784 45 .6%

Other Contracts $49,644 0 .8%

Fees $1,961,310 31 .1%

Total Revenue $6,308,526

Expenses Salaries $3,002,451 47 .8%

Benefits $1,244,830 19 .8%

Training/Travel $90,886 1 .4%

Supplies $424,485 6 .8%

Building Costs $532,775 8 .5%

Services $687,341 10 .9%

Insurance $32,778 0 .5%

Controlled Assets/Equipment $75,517 1 .2%

Capital Projects $186,116 3 .0%

Total Expenditures $6,277,179

Contribution to/(from) Fund Balance $31,347

2009 Annual Report

477 23rd Street • Ogden, Utah 84401

236 East Young Street • Morgan, Utah 84050

www.webermorganhealth.org