Dorchester County Health Department 2012 Annual Report

July 1, 2011 - June 30, 2012

Roger L. Harrell, M.H.A., Health Officer

3 Cedar Street, Cambridge, MD 21613

(410) 228-3223; Fax (410) 228-9319

Dorchester County Addictions Program District Court Lower Level 310 Gay Street

Cambridge, MD 21613 (410) 228-7714; Fax (410) 228- 8049

Photo by: Julie Jones

A Message from the Health Officer

The Dorchester County Health Department is a unit of the Maryland Department of Health and Mental Hygiene and services are provided in a non-discriminatory manner, by highly qualified and committed professionals. Our Mission is: “From disease prevention to crisis intervention, from birth to death, we are working in partnership with the community to make a safer place for healthier people”.

It is my responsibility as Health Officer to assure that essential public health services are provided to the citizens of Dorchester County. I believe that we are preserving, protecting and promoting the health of all County residents, even during trying fiscal times. Furthermore, the successes we claim are a direct result of our strong community partnerships which allow us to utilize our resources most effectively.

Prevent epidemics and the spread of disease Protect against environmental hazards Prevent injuries Promote and encourage healthy behaviors Respond to disasters and assist communities in recovery; and Assure the quality and accessibility of health services.

This report is designed to identify the accomplishments made in each of these categories during the Fiscal Year 2012 (July 1, 2011– June 30, 2012). If you have any questions or comments about the work of the Health Department, of if you would like to partici-pate in one of our programs, please call us at 410-228-3223.

Roger L. Harrell, M.H.A. Health Officer

A Special Thanks To All Of Our Community Partners (Including, but not limited to)

Associated Black Charities (ABC) Child Fatality Review Team Choptank Community Health Systems Dorchester County CMCA Team Dorchester Criminal Justice Network Dorchester County Drug & Alcohol Abuse Council Dorchester County Family YMCA Dorchester County Infant Mortality Coalition Dorchester County Public Schools Dorchester County Recreation and Parks Dorchester County Safe Routes to School Taskforce Dorchester County Service Providers Dorchester County Wellness Coalition Dorchester Recovery Initiative (DRI) Eastern Shore Area Health Education Center Local Law Enforcement Partnership for a Drug Free Dorchester (PDFD) Shore Health

Demographics Dorchester Maryland

POPULATION DATA 2010 U.S. Census

Total Population, 32,618 5,773,552

% White Persons 67.6% 58.2%

% African American Persons 27.7% 29.4%

% Asian Persons 0.9% 5.5%

% Persons of Hispanic or Latino Origin 3.4% 8.2%

ECONOMIC INDICATORS Median household income, 2006-2010 U.S. Census 2006-2010 American Com-munity Survey

$45,151 $70,647

Persons below poverty, percent, 2010 U.S. Census Bureau, SAIPE 2010.

16.2% 9.9%

OTHER INDICATORS

High school graduation rates, 2011 2012 Maryland Report Card

78.53 82.82

Bachelor's degree or higher, 2012 2012 American Community Survey

31.4% 36.9%

Selected Risk Factors County State

Current Overweight % 36.1 38.2 Current Obesity % 38.2 27.7 Diabetes Lifetime Prevalence % 14.7 9.4 Binge drinkers (5+ drinks per occasion last 30 days) % 15.0 14.6 Chronic drinkers (Males 2+, Females 1 drink per day) % 4.4 4.5 Current Cigarette Smoking by Adults 13.9 15.2 Prevalence of Tobacco Use by Underage Youth 19.7 15.6 *% Households with minor children in which adults smoke. 32.2 29.6

Sources: Maryland BRFSS 2010; *Monitoring Changing Tobacco Use Behaviors in Maryland.

Deaths from Selected Causes County State *Death rates are not calculated for jurisdictions with fewer than 20 deaths.

Cerebrovascular Disease 16 2,262 Diabetes 9 1,186 Motor Vehicle Accidents 3 506 All Other Accidents 8 934 Chronic Lower Respiratory Diseases 16 2035 Influenza and Pneumonia 6 922 Suicide 4 505 Alzheimer’s Disease 8 982 HIV 2 315 # of infant deaths – Black 3 295 # of infant deaths – White 1 178 # of infant deaths – Hispanic 0 42

Source: Maryland Vital Statistics Annual Report 2009

Cancer Incidence Rates (2007) County State All Cancers 463.0 455.3 Lung & Bronchus 76.2 62.4 Colorectal 57.0 41.6 Female Breast 123.2 123.2 Prostate 127.3 162.5 Oral < 6 Cases 9.6 Melanoma 7 Cases 21.2 Cervical < 6 Cases 6.4 Source: Annual Cancer Report Cigarette Restitution Fund Program, December 2010 * Rates are per 100,000 population and are age adjusted incidence to 2000 U.S. stand-ard population.

Vital Records - Provides walk-in services to qualified applicants for birth and death records. * 917 birth certificates processed. * 2150 death certificates/copies processed.

Preventing Epidemics and the Spread of Disease

Communicable Disease Surveillance and Outbreak Control - Reports of communicable diseases are collected, investigated, and analyzed to alert physicians and the public of trends and unusual occurrences. When an outbreak occurs, appropriate action is taken to stop or control the outbreak.

2 outbreaks occurred 156 investigations were conducted on reportable diseases

Immunization Program – Ensures that adults and children in Dorchester County are immunized appropriately. Provides annual influenza immunizations.

217 children received required immunizations Vaccines administered at Health Department - 736 season flu , 30 pneumonia and 106 Hepatitis B 990 seasonal flu vaccines administered in schools

HIV/AIDS Prevention Program – Educates about HIV/AIDS transmission and prevention. Provides HIV counseling and testing services. Provides education programs to community groups.

598 people received counseling and testing services

Rabies Control - Tests suspected animals and ensures preventive treatment for persons possibly exposed to the disease. Pre-exposure immunizations are available year round for at risk individuals.

6 rabies vaccination clinics held, 526 vaccinations given 254 animal bite investigations were conducted, 37 specimens tested for rabies with 5 testing positive for rabies, including

4 raccoons and 1 cat. 12 people received pre-exposure immunizations

Lead Poisoning Prevention 82 children were screened for lead poisoning 7 children were tested for lead poisoning 2 community Lead Poisoning educational and outreach activities were conducted

Protecting Against Environmental Hazards

422 retail food facility inspections 175 retail food licenses issued 227 temporary food event permits issued 161 well construction permits issued 220 well inspection & water sampling conducted 206 other water tests conducted 27 septic system site evaluations 86 septic system construction permits issued 65 septic system inspections 58 septic system contractor licenses issued 53 failing septic systems repaired 70 environmental nuisance investigations 46 sanitary surveys conducted 19 annual swimming pool operating permits issued 57 public swimming pool inspections conducted

Responding to Disasters and Assisting Communities in Recovery

Public Health Emergency Preparedness - Works in collaboration with Dorchester County Emergency Management Agency and other partner agencies to respond to and provide public health services in emergencies. Planned and participated in three multi-agency preparedness exercises. Staff are available on a 24-hour basis for public health emergencies.

Promoting and Encouraging Healthy Behaviors Tobacco Use Prevention and Cessation - Provides prevention and cessation education and services. Provided 21 Tobacco Prevention/Cessation Education Presentations Educated 189 individuals regarding consequences of tobacco use and availability of services Participated in 59 outreach events Reached 3241 individuals with tobacco prevention/cessation information 124 county residents participated in stop smoking programs 53 county residents received nicotine replacement therapy

Promoting and Encouraging Healthy Behaviors

Drug & Alcohol Prevention Programming (DAPS) - Develops and implements the County’s substance abuse prevention plan; networks with community groups and organizations to strengthen community substance abuse programming. FY 2012 accomplishments include: Four-hundred and ten (410) residents received substance abuse prevention presentations Five (5) community organizations provided Second Step lessons to 180 students, aged 3 to 17 Two (2) community organizations provided Freedom Writers sessions to 39 students, aged 4 to 17 In concert with PDFD, sponsored 14 Substance Abuse Prevention media events, conducted with local media

venues. One media campaign, co-sponsored with Talbot County Health Department, included a website: www.parentonthescene.org

Partnership for Drug Free Dorchester (PDFD) - Coalition to enhance the coalition's goal of providing a comprehensive environmental approach to addressing substance abuse prevention County-wide. FY 2012 PDFD accomplishments include: “Positive Community Norms Initiative” training with 27 community members participating 40 Developmental Asset training: “Everyone’s An Asset” attended by 19 community members Established a You Tube account: www.youtube.com/drugfreedorchester. Conducted Prescription Take Back Day on 10/ 29/11 with 118 lbs. collected and on 4/28/12 with 227 lbs. col-

lected

The Youth Action Council (YAC) - guided by PDFD, provides the county’s youth population with a voice and struc-ture to appropriately address these concerns on their age level. FY 2012 accomplishments include:

Eleven (11) youth ages 11-18 participated as members of the YAC YAC members attended 3 trainings to enhance leadership and media literacy skills YAC sponsored the “Youth Event”, attended by 28 county youth, aged 5 to 17 YAC developed, produced and starred in a video PSA entitled, “I’d Rather…”,

which premiered on a local television station and You Tube.

Safe Routes to School Project - Addresses bicycle and pedestrian safety through infrastructure improvement, education and enforcement contracts with law enforcement

Promoting and Encouraging Healthy Behaviors

Girls Circle - Case Management, Support Services and Group Sessions provided to at-risk adolescent girls and pregnant and parenting teens in both county high schools geared toward keeping them in school and planning for the future.

Seventy-three (73) young women were served Group sessions focused on developing goals, life skills, job readiness, and enhancing parenting skills None of the teens actively involved in the program reported a pregnancy. The teen birth rate in Dorchester County dropped from 77.5 (births to teens aged 15-19 years per 1,000 population) in 2008 to 55.1 in 2010

Personal Responsibility Education Program - Community partnerships provide age appropriate education for teens and pre-teens promoting healthy and responsible behaviors.

Provided mini-grants to five non-profit and faith-based organizations to conduct evidence-based comprehensive teen pregnancy and STI pre-vention program

Reached a total of 83 middle and high school aged youth with programs

Assuring the Quality and Accessibility of Health Services School Health - Health Services provided in all public schools in partnership with the Dorchester County Board of Education. 4,647 student health information forms and records reviewed for immunization compliance 61,663 student health room visits 18.784 Physician authorized medications administered to students 1,856 vision and hearing screenings and 1,179 head lice screenings conducted Health concern contacts made to parents (9,267), teachers (3,946) and physicians (1,654) 299 students counseled by school nurses, 482 students referred to School Based Wellness Centers by school nurses

School-Based Wellness Centers - Provide somatic and mental health services by licensed clinicians in four schools: Maces Lane Middle, Cambridge-South Dorchester High, North Dorchester Middle, & North Dorchester High.

Eighty-seven per cent (87%) of the total student population was enrolled in the program Nurse Practitioners provided 2,271 individual visits Mental Health Clinicians provided 1,768 individual and family sessions The program received a federal grant from the Health Resources and Services Administration to purchase a

new modular building for the Wellness Center on the North Dorchester High campus, providing a better healthcare facility and allowing the school to reclaim space for academics.

Youth Services Bureau (YSB) - The Health Department became certified as a Maryland State YSB in October of 2011 to provide services to children and youth involved with the juvenile justice system. Services included informal and formal counseling and group sessions. About one-half of those referred by the Department of Juvenile Services for YSB involvement later received mental health evaluations and began treatment with School-Based Wellness Center clinicians.

Assuring the Quality and Accessibility of Health Services

Elementary Behavioral Health Program - Mental Health services provided by two licensed clinicians in four of the county’s elementary schools.

One hundred fifty-six (156) children were served with 1,186 individual, family and group sessions Group session topics included everything from social skills to coping with family stress. A group for children who had been victims of sexual trauma was also started at one school

Healthy Families Dorchester - Intensive home visiting for pregnant women and families with newborns. Staff pro-vide information and activities designed to promote attachment and bonding; positive parent-child interaction; age-appropriate expectations and discipline; and healthy child development.

Sixty-three (63) families received intensive home visiting services Ninety-five percent (95%) of children were up-to-date with immunizations All children were screened to determine if they were developing appropriately

Maryland Children’s Health Program (MCHIP) - Processes applications for medical insurance program for children and pregnant women. 804 new applications were received and processed 837 renewal applications were processed 733 individuals were certified under the Medicaid for Families expansion

Administrative Care Coordination/Ombudsman Program (ACCU) - Assists clients with Medical Assistance in resolving problems accessing care, and educating the community on MCHP and HealthChoice.

578 referrals received 3836 clients were assisted 15 children with special needs were identified and referred as appropriate 6 Educational presentations conducted 7374 Telephone calls received

Family Planning - Provides individuals the information and means to exercise personal choice in determining the number and spacing of their children.

1,354 Family Planning visits serving 587 clients

Colposcopy Program - Provides services for uninsured/underinsured women of childbearing age who are at-risk of developing cervical cancer . This program served 41 clients

Cancer Screening Program - Provides education and screening for colorectal, breast and cervical cancer 384 county residents were individually educated about the importance of colorectal cancer screening 62 county residents received colonoscopy screening for colorectal cancer 640 women received breast and cervical cancer education 192 women received mammograms

Assuring the Quality and Accessibility of Health Services

Medical Transportation - Provides transportation to non-emergency medical appointments for Medicaid recipients. 18,098 total passenger trips equaling 391,890 total miles transported 213 ambulance trips equaling 7,124 ambulance miles transported 975 unduplicated clients served

Adult Evaluation and Review Services: Evaluates individuals with chronic medical, functional or psychosocial issues to enhance or to prevent disruption of their living situation. 386 comprehensive evaluations 311 information and referral contacts

MA Personal Care: Provides linkages and case monitoring between self-employed providers and MA recipients requiring assistance with daily living activities due to chronic medical condition. 194 face to face home visits Monthly oversight to 35-46 clients. Bi-monthly contact with providers as well as additional

contacts with clients, family members and local agencies.

Developmental Disabilities Program—Provides service case management to children and adults. 139 individuals were provided on-going case management 29 new referrals were received Conducted 83 annual assessments for individuals receiving residential services at Holly Center

Outpatient Substance Abuse Assessment & Treatment for Adults and Adolescents 612 adult and adolescent diagnostic assessments completed 739 clients served, adult and adolescent 8641 adult and adolescent group sessions 2782 adult and adolescent individual sessions 62 clients received services at detention center 167 clients successfully completed outpatient treatment

The DRI-DOCK Recovery & Wellness Center was launched in March of 2012. The Center offers a wide range of recovery-oriented ser-vices & activities. We offer a Women’s only group, Veteran’s, Trauma, Smoking Cessation, Emotions Anonymous, and Depression Support groups. The Center also offers 12-Step Mutual-Aid meetings and houses a Computer Lab which remains highly utilized. Peer Recovery Support Specialists and a Care Coordinator base their operations out of the DRI-DOCK Recovery & Wellness Center, providing case management and offering financial assistance for recovery support services (such as transportation, housing support, etc.) to those that qualify.

Dorchester County Health Department, FY 2012 Annual Report - December 2012

Compiled by: Health Education/Community Outreach Program