To promote and enhance the health of all individuals
through education, prevention, intervention, and
protection of the environment.
2011 Annual Report
Serving Crawford, Kalkaska, Lake, Manistee,
Mason, Mecosta, Missaukee, Newaygo, Oceana,
and Wexford counties.
2
Health Officer and Board of Health
Dear DHD#10 Constituents:
The work of District Health Department #10
continues to evolve around the core functions of
public health: assessment, assurance, and policy
development. Over the past year we began to work
with our healthcare partners to develop a community
health assessment and health improvement plan for
the health district. This work was initiated by
collaborating with the hospitals in our health
jurisdiction and with the Tencon Health Plan and will provide a strong foundation over the
next five years to target specific health priorities using evidence based strategies. The
Michigan Department of Community Health has also engaged in a community health
assessment process and established a Michigan Chartbook on key public health indicators.
DHD#10 has aligned our own databooks with the MDCH product and these can be found on
our website.
Governor Snyder has identified obesity and infant mortality as two key public
health priorities; we appreciate his recognition of the importance of these fundamental
public health needs. This past fall, a summit was held around each of these priorities.
Locally, DHD#10 has services which touch on each of the priorities and looks to the future
for collaborating with community partners to implement local initiatives.
The department continues to look to using quality improvement measurers as
financial resources to the department shrink. We strive to be as efficient as possible with
resources. A reduction to Essential Local Public Health Services and Healthy Michigan
Fund line items continues to create a challenge for the department in implementing
mandated services and complying with program requirements that are not shrinking along
with the funding.
The department continues to move forward with the implementation of
meaningful use for electronic medical records, has integrated human resources and the
finance department into an updated software system, and has the electronic foodservice
inspection portion of Healthspace operational.
I am proud of the work done by our public health staff; they continue to be client
centered, focused upon improving quality, and driven to be more efficient. They continue
to keep a positive attitude during these difficult times facing Michigan residents. We are
hopeful the future will bring a renewed emphasis upon population based outcomes and
primary prevention aimed at improving the health status of our residents.
Sincerely,
Linda VanGills, MA
Health Officer
2011
Board of Health
Crawford County
Shelley Pinkelman
Kathy Rogers
Kalkaska County
Carroll Sexton
Deb Kimball
Lake County
Ken Wenzel
Colleen Carrington
Manistee County
Ken Hilliard
Jim Krolczyk
Mason County
Robert Erickson
Susan Boes
Mecosta County
Art Adleman
Ray Steinke, Vice Chair
Missaukee County
Susan Rogers
Hubert Zuiderveen
Newaygo County
Stanley Nieboer
Simon (Sam) Scholtens,
Secretary
Oceana County
Evelyn Kolbe, Chair
Larry VanSickle
Wexford County
Jerry Bulock
Alan Devereaux
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Public Health Core Functions:
Assessment, Assurance and Policy Development
District Health Department #10’s Accomplishments in Essential Public Health Services
1. Monitor health status to identify problems
Worked with local hospitals to move forward with a collaborative community health assessment between health care and public health.
Worked with Continue-Care of Spectrum Health Gerber Memorial Hospital to plan transitioning clients in their MIHP program into District Health Department #10’s MIHP.
2. Diagnose and investigate health problems and health hazards
Developed capacity to process surface water samples for beach testing.
Worked with several of the nursing home facilities in DHD#10’s jurisdiction on outbreaks of Norovirus and recommended follow-up procedures to decrease transmission of the virus.
3. Inform, educate and empower people about health issues
Expanded Breastfeeding Peer Counselor Program to all ten counties.
Increased participation in WIC nutrition education through quality improvement project.
Increased client assessments in the MIHP Program through the Assessment Quality Improvement Project in collaboration with the WIC Program.
4. Mobilize partnerships to identify and solve health problems
Worked with Manton and Mesick Public Schools to implement adolescent wellness program.
Collaborated on new prenatal smoking prevention program with Mercy Hospital Cadillac.
Conducted staff meetings with employees from Department of Human Services in Mecosta, Newaygo, Oceana, and Mason counties to review agency services and identify gaps in health care.
5. Develop policies and plans that support individuals and statewide health efforts
Completed a regional strategic plan by the Northwest Michigan Cancer Prevention and Awareness Coalition to improve cancer outcomes.
Worked with Michigan Department of Community Health on outcome based data in the MIHP Program.
Assisted the City of Ludington, City of Big Rapids, and Pere Marquette Township to adopt Complete Streets resolutions.
Secured financial resources to assist in the implementation of the Double Up Food Bucks program in Manistee.
6. Enforce laws and regulations that protect health and ensure safety
Followed up on complaints from the Smoke Free Law.
Enforced the school immunization laws by working with the schools and adding immunization clinics to reduce vaccine preventable diseases.
7. Link people to needed health services and assure the provision of health care when otherwise unavailable
Trained clinic staff in processing Medicaid and MiChild applications to improve health care access, specifically for pregnant women and children.
Trained Personal Health staff in child abuse updates and addiction to improve resource information for staff and clients.
8. Assure competent public and personal health care workforce
Worked with Ferris State University to expand public health nursing experience for BSN students.
Worked with Baker College to expand public health nursing in the pediatric field for their Associate nursing students.
Sent four staff members to nationally accredited, Tobacco Treatment Specialist training to provide intervention to pregnant women who smoke.
9. Evaluate effectiveness, accessibility and quality of personal and population-based health services
Collaborated with Tencon Health Plan to respond to health needs of the uninsured adult population.
10. Utilized research for new insights and innovative solutions to health problems
Implemented an electronic reporting system for the food inspection program.
Moved forward with implementation of electronic medical record.
Implemented an electronic communicable diseases reporting system for schools.
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Medical Director
Dear Community Residents,
Public Health’s ability to provide the ten essential services of Public Health is directly dependent, in large measure, by funding, so advocacy is very important to our success. DHD#10 provides the essential services with efficiency, ongoing training, and with the use of Information Technology (IT). In the future, our goals and services in the healthcare system in America will be more important because of the recognition of primary prevention. This recognition and reorganization will be necessary to assist with cost controls. The release of “National Prevention Strategy: America’s Plan for Better Health and Wellness” will assist all health care providers to move forward with disease prevention and management.
Public Health continues to recognize the role that social detriments, such as access to care, poverty, education, other psychosocial and environmental issues, have on human health. I am thankful I live in America, but I believe we can do better in this country to improve the lives and health of our citizens. We can assist in improving the general wellbeing. Our local District Health Department #10 has numerous programs to accomplish these goals.
Challenges this year are to integrate us with the Healthcare System using EMR (electronic medical records), to respond to the new Healthcare Law, to improve access to and quality of medical care, to be on the alert for new Novel Influenza virus outbreaks and other communicable diseases, to ensure a safe food and water supply, to help protect citizens against the adverse affects that tobacco has on health, and to immunize our population and to promote health.
Sincerely,
Dr. James Wilson, D.O., M.P.H.
Emergency Preparedness
Focuses on minimizing the effects of infectious disease outbreaks and other threats to
public health by collaborating with local, regional, state, and federal agencies.
Facts about Emergency Preparedness:
In 2011, DHD #10 Emergency Response Staff continued to review, update, or create guidelines to better prepare DHD #10 for public health emergencies that may occur within our jurisdiction. One example of a guideline created in 2011 was the Emergency Operations Guideline (EOP). This guideline is considered the “base” document that ties all other public health emergency response guidelines together. Another newly created guideline was the Mass Vaccination Guideline specifically developed to provide direction during an event like H1N1 pandemic flu.
Staff participated in several exercises in order to practice emergency response techniques. One example was a Distribution Node (DN) exercise. This was a full-scale exercise where staff had to receive a shipment of pretend medication, track the inventory, sort the medication, package the medication for distribution to our other counties, and communicate with internal staff and external partners.
Staff continued to work with our local partners in emergency management, law enforcement, health care, schools, and human service organizations to ensure our communities are ready to respond to a variety of public health challenges.
Participating in the Distribution Node Exercise is
Rich Kinsey, Ted Dohnal, and Karen Ripke.
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Our Values
Integrity
Responsibility
Accountability
Customer Service
Positive Attitude
Communication
Public Health Workforce
Employs and maintains a competent workforce through
consistent administration and application of the agency’s
personnel policies.
Years of Service
5 Years
Kyle Anderson, EH Sanitarian
Matt Fournier, EH Sanitarian
Frank Palatka, EH Sanitarian
Jessica Podbilski, WIC Tech
Kim Chandler, Health Educator
Barb Fox, Maternal/Child Nurse
10 Years
Darlene Ninnemann, PH Support
Lori Gelinas, Public Health Nurse
Gretchen Cooper, Public Health Nurse
Joanna Durfee, Maternal/Child Nurse
Pam Brown, Clerical Team
Mandy LaFave-Vogler, Maternal/Child Nurse
Lisa Burmeister, Maternal/Child Social Worker
Karen Gallucci, Maternal/Child Nurse
Brenda Freeman, EH Sanitarian
Robin Walicki, RN Case Manager
15 Years
Meryl Smith, WIC Lead
Terry Babcock, WIC Tech
Carol Lambert, Maternal/Child Nurse
Janelle McGinnis, WIC Nutritionist
20 Years
Tia Brown, Vision Tech
Sue Lucksted, Public Health Nurse
25 Years
Joyce Kelley, Executive Secretary
Trish Smith, Hearing and Vision Tech
Cel Southard, Clerical Team
Pattie Schneider, Public Health Nurse
Sharon Polek, MCIR System Coordinator
Carol Sellers, Clerical Team
30 Years
Chris Anthony, HP Support
Congratulations to Joan Wise,
Personal Health Director, who
celebrated 40 years of service with
District Health Department #10!
“Quality public health is all about great
teamwork. I have been blessed to be
part of the DHD#10 team.”
Facts about our staff:
The diverse work force includes registered nurses, health educators,
environmental health sanitarians, social workers, dietitians, support staff,
paraprofessionals, clinic technicians, computer technicians, accounting staff,
administrative assistants, and human resource staff.
Of the 170 employees, 144 are full time, 24 are part time, and 2 are contractual.
The average years of service is 13.7 years. Within our staff, 26% have 20 or
more years of service. Thirteen employees have over 30 years of service.
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Administrative Services
Comprises the financial management, accounting, billing, information systems,
and office support staff.
DHD#10 Revenues and Expenditures
FY11
State Funding 4,973,453 27.81%
County Appropriations & Space 2,879,262 16.10%
Insurance Collections/Fees 1,988,701 11.12%
Medicare/Medicaid 5,119,116 28.62%
Essential Local Public Health Services 1,292,357 7.23%
Other Grants/Contracts 583,394 3.26%
Tencon Services 1,019,555 5.70%
Cigarette Tax 29,769 0.17%
Total Revenues 17,885,607
Wages 7,238,680 42.62%
Fringes 3,923,668 23.10%
Travel 468,647 2.76%
Supplies 1,016,403 5.98%
Contractual 623,918 3.67%
Communications 119,694 0.70%
Capital Outlay 413,062 2.43%
VFC Vaccine Value 653,683 3.85%
Space 1,240,738 7.30%
Tencon Services 1,019,555 6.00%
Other: Maintenance, Education/Training, Liability Insurance, Board of Health
267,338 1.57%
Total Expenditures 16,985,386
Fund Balance 900,221
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Communicable Diseases
2008-9 2009-10 2010-11
Flu-like disease 5,886 11,785 5,850
Strep throat 865 529 1,012
Head lice 1,175 753 691
Chlamydia 452 476 526
Gastrointestinal n/a 335 491
Hepatitis C (chronic) 132 157 145
Campylobacter 34 48 48
Gonorrhea 26 27 36
Chicken pox 38 30 34
Salmonellosis 23 14 23
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Oceana Wexford
Flu-like disease 235 473 989 349 176 618 237 1804 74 895
Strep throat 137 100 7 73 67 115 79 242 44 148
Head lice 43 55 63 36 57 168 19 105 9 136
Chlamydia 28 43 16 30 28 136 30 82 48 85
Gastrointestinal 24 <5 0 0 0 <5 50 410 <5 0
Hepatitis C (chronic) 15 13 17 20 9 9 7 27 12 16
Campylobacter <5 0 <5 6 5 9 10 8 <5 5
Gonorrhea <5 <5 <5 <5 <5 7 <5 6 <5 11
Chicken pox <5 6 0 0 0 <5 <5 9 <5 11
Salmonellosis <5 <5 0 0 <5 7 <5 <5 <5 <5
Communicable Disease Facts:
Chlamydia and Chronic Hepatitis C are our most common
communicable diseases. Influenza-like illness has a greater
number of cases but those are not confirmed.
Trends in communicable diseases over the past three years show
increases in Chlamydia and Gonorrhea. A decrease was found in
pertussis. Gastrointestinal illness, Campylobacter, Salmonellosis,
and Hepatitis C remained about the same.
Although there was only one case of rabies this past year, the
high fatality rate and fear of this disease requires a great deal of
staff time to investigate, follow-up, and educate the public.
A suspected case of Botulism also required a great deal of staff
time, although it was not confirmed. This also involved
coordination with law enforcement, the court system, the
Michigan Department of Agriculture, the state laboratory, and
hospitals.
There was one confirmed case of Tetanus in 2010, demonstrating
how important immunizations are to prevent against this
disease.
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DHD#10
Number of deaths
DHD#10
Death rate per
100,000
Michigan
Death rate per
100,000
Heart disease 615 187.4 206.5
Cancer 607 180.6 181.9
Chronic lower respiratory 185 55.4 45.1
Stroke 140 43.7 39.9
Unintentional injuries 134 49.0 35.4
Diabetes 78 23.4 24.3
Alzheimer’s disease 81 25.9 22.9
Kidney disease 41 12.8 15.5
Pneumonia/Influenza 45 13.7 13.9
Suicide 38 13.6 11.3
Leading Causes of Death
In Governor Snyder’s Health and Wellness message in September, 2011, he begins by talking about building a healthier Michigan, both on the individual and community level. When we look at the leading causes of death in our communities, almost all could be impacted by healthier behavior. Governor Snyder states, “Wellness and economics are linked. For example, costs due to coronary heart disease (CHD), the most prevalent and preventable form of heart disease, exceed $5.9 billion per year in Michigan. Treatment of heart disease accounts for 1 in every 6 health care dollars spent. But even modest improvements in wellness can significantly reduce our risk of CHD and similar chronic conditions. While economic considerations are certainly important, the real value of a healthy lifestyle is quality of life. The good news is that evidence-based practices have demonstrated that each of us can significantly improve our personal health by practicing four key healthy behaviors:
maintain a healthy diet;
engage in regular exercise;
get an annual physical examination; and
avoid all tobacco use.
In conjunction with these key health behaviors, we should all be aware of four key health measures that are closely tied to the incidence of chronic disease:
body mass index (BMI);
blood pressure;
cholesterol level; and
blood sugar level. Taken together, these four behaviors, and four measures, can be characterized as the Michigan 4x4 plan. If each of us practice the Michigan 4x4 plan, our lives will be fuller, our health costs dramatically reduced, and our ability to take advantage of all that is Michigan enhanced.” District Health Department #10 and its partners provide a wide variety of programs, services, and policies to address building healthy individuals and communities within our jurisdiction, to support building a stronger Michigan.
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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data Source
Michigan 25.0% 25.4% 25.2% 25.4% 26.2% 28.8% 28.2% 29.5% 30.3% 31.7% Centers for Disease Control and Prevention U.S. 20.9% 21.9% 22.9% 23.2% 24.4% 25.1% 26.3% 26.7% 26.9% 27.5%
2006-2010 Overweight and Obesity
Overweight Obese
Michigan Behavior Risk Factor Survey,
2006-2010
Michigan 30.1% 35.6%
DHD#10 39.1% 31.1%
Crawford 45.6% 27.4%
Kalkaska 39.8% 29.5%
Lake 36.1% 43.1%
Manistee 49.8% 21.7%
Mason 53.0% 28.0%
Mecosta 32.2% 28.7%
Missaukee 33.5% 32.7%
Newaygo 31.7% 28.7%
Oceana 40.5% 38.5%
Wexford 39.6% 37.0%
The Healthy People 2020 target for obesity is 30.6% for adults
aged 20 and older.
Obesity is a major contributor to cardiovascular disease, cancer, and diabetes. It also negatively impacts public health costs and educational outcomes. Individuals with a body mass index (BMI) of 30 or greater are considered obese. Overweight is defined as a BMI greater than or equal to 25 but less than 30. Weight and height are used to calculate BMI, which provides a reasonable indicator of body fat and weight categories that may lead to health issues.
Public Health Priority:
Obesity
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Measure 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Data Source
Rate of infant deaths per 1,000 live births.
Michigan 8.1 8.1 8.1 8.4 8.2 7.8 7.8 7.6 7.6 7.7 America's Health
Rankings U.S. 7.1 7.0 6.9 6.8 6.7 6.7 6.8 6.8 6.8 6.7
Five year moving average
1997-2001
1998-2002
1999-2003
2000-2004
2001-2005
2002-2006
2003-2007
2004-2008
2005-2009
Michigan Department
of Community
Health
Michigan
Rate 8.1 8.1 8.2 8.1 8.0 7.9 7.9 7.6 7.6
A five year moving average is used to compare DHD#10 and counties to the five year moving average in Michigan because of the small number of deaths.
Deaths 1085.0 1078.8 1083.0 1065.6 1045.8 1020.6 1009.2 965.6 945.0
DHD#10 Rate 7.5 7.6 7.3 7.3 7.6 7.3 7.4 7.1 7.1
Deaths 22.8 23.4 22.6 22.4 23.2 22.6 23.2 22.2 21.8
Crawford Rate 12.5 14.3 15.7 13.1 10.7 8.9 13.5 12.1 13.6
Deaths 1.8 2.0 2.2 1.8 1.4 1.2 1.8 1.6 1.8
Kalkaska Rate 6.7 7.6 7.2 7.2 8.1 8.3 5.3 * *
Deaths 1.4 1.6 1.6 1.6 1.8 1.8 1.2 0.8 0.8
Lake Rate * * * * 12.8 14.0 13.7 * 10.5
Deaths 0.4 0.4 1.0 1.0 1.4 1.6 1.6 1.0 1.2
Manistee Rate * 4.9 8.6 9.4 11.9 11.4 9.8 6.0 6.2
Deaths 1.0 1.2 2.2 2.4 3.0 2.8 2.4 1.4 1.4
Mason Rate 11.7 9.1 9.0 8.2 5.9 5.7 5.6 4.9 5.6
Deaths 3.6 2.8 2.8 2.6 1.8 1.8 1.8 1.6 1.8
Mecosta Rate 9.2 9.4 7.1 8.6 7.7 6.9 6.3 8.9 6.6
Deaths 4.4 4.6 3.4 4.0 3.6 3.2 2.8 4.0 3.0
Missaukee Rate * * 8.0 7.0 * * * * *
Deaths 1.0 1.0 1.4 1.2 1.0 1.0 1.0 0.4 0.6
Newaygo Rate 5.4 5.4 4.8 5.2 5.2 5.4 7.1 7.5 7.6
Note: * indicates too small to calculate
Deaths 3.4 3.4 3.0 3.2 3.2 3.4 4.6 4.8 4.8
Oceana Rate 6.7 8.2 5.5 7.4 9.9 9.4 8.2 8.6 7.9
Deaths 2.4 3.0 2.0 2.8 3.8 3.6 3.2 3.4 3.0
Wexford Rate 8.8 8.6 7.6 4.6 5.4 5.3 6.6 7.3 7.8
Deaths 3.4 3.4 3.0 1.8 2.2 2.2 2.8 3.2 3.4
Public Health Priority:
Infant Mortality
Infant mortality is a critical indicator of the overall health and welfare of Michigan and the quality and accessibility of prenatal care for women. The infant mortality rate represents the number of infant deaths before age one per 1,000 live births.
The Healthy People 2020 Target for infant mortality is 6.0
deaths per 1,000 live births.
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Environmental Health Monitors and protects the public’s food, air, and water through community
inspection, education, and enforcement of environmental rules and laws.
Environmental Health
District Wide Data
Water Supply Program
Well Permits 1,312
Well Inspections 385
Type II Sanitary
Surveys 201
On-Site Sewage
Septic Permits 1,068
Denied Permits 6
Final Inspections 933
Mortgage Evaluations 250
Building Permit
Approvals 263
Soil Evaluations 47
Food Safety
Fixed Food
Establishment
Inspections
2,011
Temporary Food
Establishment
Inspections
615
Food-Borne Illness
Investigations 34
Community Health and Safety
Campground
Inspections 260
Swimming Pool
Inspections 165
Child Care Facility
Inspections 237
Complaint
Investigations 256
Environmental Health Highlights:
Through a two year grant from the US EPA, the health department will be able to conduct additional water sampling at four Lake Michigan beaches during high use times and after major rain episodes. DHD#10 has also created its own water sampling laboratory in the Ludington office, eliminating the cost of contracting out for this service.
The District purchased laptops for all of the food program inspectors. The use of computers during inspections will save time, allow for computer searches, and provide email delivery of the final report.
The District increased its outreach to the public by hosting training sessions for septic system contractors and for the contractors in the mortgage evaluation program. The District produced a newsletter for all licensed food operators to keep them informed on the new food safety issues. There were also many interviews with local radio, newspaper and television reporters.
Since the Michigan Smoke-Free Workplace law went into effect in May of 2010, the Division has been the main investigation and enforcement agent for the law. This has consisted of site visits for each complaint received, evening surveillance at some locations, informal hearings, and formal hearings.
Public Health Staff...Making a Difference
DHD#10 was in the news in July 2011 due to water samples taken at a
children’s camp showing E.coli bacteria. It is not uncommon to find E.coli in a well and
its presence is a high public health concern. The Health Department assisted camp
operators with a press release and letters to parents and fielded phone calls from
concerned parents. The camp was closed for two weeks while the well was chlorinated
several times and many samples were collected. Finally, an acceptable level of water
quality was obtained and the camp reopened. Environmental health staff make a
difference in protecting the health of our communities.
The Environmental Health Staff conduct campground inspections.
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Health Promotion
Provides health risk assessment, risk reduction, and health intervention services targeting
public health priorities aimed at improving health outcomes.
Health Promotion
Youth Programs
Girls on the Run
Participants 1,071
Students Served at
Wexford Adolescent
Wellness Center
302
Students Participating
in Teen Pregnancy
Prevention Initiative
824
Family Health Programs
Breast and Cervical
Cancer Screening 1,544
WiseWoman
Screenings 1,384
WiseWoman Follow-up
Contacts 2,981
Colorectal Cancer
Screening 393
Family Planning
Participants 2,889
Tencon Screenings 859
Health Promotion Highlights:
In addition to the Wexford Adolescent Wellness Center at Cadillac Junior High School, two new school-based health centers opened in Mesick High School and Manton High School. Services are offered for youth age 10-21 in Wexford County and include nursing services, mental health counseling and therapy, health education, and immunizations.
Building Healthy Communities grant funds from the Michigan Department of Community Health have promoted environmental and policy changes to improve healthy eating, physical activity, and tobacco-free lifestyles. Examples of environmental changes to promote healthy eating include a new community garden at Rapid City Elementary School, a new community garden in Fremont, and enhancements to the community garden at Cornerstone Apartments with the addition of a hoop house. An enhanced mountain bike trail in Ludington promotes physical activity. An example of policy changes
include designating the mountain bike trail and community gardens as tobacco-free. The adoption of Complete Streets resolutions in Big Rapids, Ludington, and Pere Marquette Township reflect policy changes to improve community health. This program was highlighted at the National Association of County and City Health Officials (NACCHO) conference last summer.
Public Health Staff...Making a Difference
When funds were available from the Michigan Department of Community Health to help WiseWoman clients with healthy eating goals, staff at the Health Department recruited seven clients to participate. Each woman received funding to set up a garden at her home to increase access to fresh, affordable, healthy foods. Staff from MSU Extension took them shopping for garden supplies and taught them how to garden. As part of the grant, they were required to attend nutrition and food preparation classes taught by the Health Department, MSU Extension, and the Manistee Community Kitchen. The program is now moving into the entrepreneurial segment, where the local gardens will generate some income for the women. With the help of the Health Department and its partners, the women have formed a WiseWoman Cooperative and applied for additional grant funding to expand their gardens. They plan to sell their products at the local farmers markets and are expanding to include honey, herbs, flavored vinegars, and artisan breads. Health Education staff recognized the unique opportunity for their clients and moved forward to make a difference.
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Personal Health
Provides preventive health services to individuals and families in clinics, homes, schools and
other community settings, focused on communicable disease control, immunizations,
and maternal-child health programs.
A young Newaygo County girl who was diagnosed with cerebral palsy and a heart condition was enrolled in our Children’s Special Health Care Services Program. She was unable to speak and was in need of a Communication Board (the only way she would be able to communicate with others). The family had no health insurance; the CSHCS Program would not cover the Communication Board. We were able to help this girl with a grant from the Fremont Area Community Foundation to purchase the Communication Board.
Our staff sees this girl on a yearly basis and comment on how wonderful it is to see her interact with others; without the board, this would not be possible. We assist children with special needs to help improve their quality of life.
Public Health Staff...Making a Difference
Personal Health Services
Immunizations
Vaccines Administered 17,039
Influenza Vaccines
Administered 13,554
Maternal Infant Health Program (MIHP)
MIHP Maternal Clients 1,025
MIHP Maternal Visits 6,944
MIHP Infant Clients 774
MIHP Infant Visits 7,582
Hearing and Vision
Preschool Hearing Screenings 3,149
School Hearing Screenings 8,291
Preschool Vision Screenings 2,898
School Vision Screenings 16,159
Communicable Disease Control
Total Communicable Disease
Services 2,510
TB Tests 1,839
STD Services 716
HIV Tests 122
Personal Health Highlights:
The Personal Health Division took the lead to host 51 nursing students from Ferris State University and Baker College during their community health rotations.
A Prenatal Smoking Cessation Grant was awarded to DHD#10 from Mercy Hospital in Cadillac. Four staff members attended a training to become Tobacco Treatment Specialists.
Training for electronic recording took place with the Hearing and Vision staff as well as the staff that provide services in the Children’s Special Health Care Services Program.
An annual grant was received from The Fremont Area Community Foundation to provide services to special needs children in Newaygo County.
An electronic communicable disease school reporting program was implemented.
Patti Gasper provides vision screening.
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Women, Infants, and Children (WIC)
Provides supplemental food and nutrition education for pregnant, postpartum,
and breastfeeding women as well as children up to the age of five.
WIC Services Provided
Average Monthly Resident Enrollment 9,592
Average Monthly Migrant Enrollment 279
Average Client Return Rate 91%
Average Breastfeeding Initiation Rate 73%
Project Fresh Coupons 3,227
$ Value of Project Fresh Coupons $64,540
Blood Lead Tests 1,273
Public Health Staff...Making a Difference
A mom brought a 10 day old baby into the WIC clinic for enrollment. The baby was taking an hour to drink two to three
ounces of formula and was below birth weight. The WIC Dietitian was concerned and requested a home visit from the MIHP nurse.
Weight gain was still inadequate and the infant’s health care provider was contacted. A referral was made to Devos Children’s
Hospital where a jaw muscle condition was identified and treated, allowing the baby to double his birth weight within the next
month. This is an example of excellent coordination of services between health department staff and community partners, focusing
on treating life threatening problems.
Ludington Community
Breast Feeding Walk participants
From Ludington Daily News
WIC Highlights:
A successful quality improvement project was initiated to “Increase WIC client participation/show rates in secondary nutrition education”. Staff developed and implemented special postcard and business card reminder systems encouraging clients to engage in internet and dietitian educational services.
DHD # 10 received $97,500 in special MDCH/USDA grant funds to implement a WIC Breastfeeding Peer Counselor Program in Lake and Mecosta Counties. The project was successful in improving breastfeeding initiation rates among the low-income WIC population.
Expansion of On-line Medicaid application service through the WIC Program; All WIC Clerk/technicians are trained and complete applications for pregnant women.
Reconvened Wexford-Missaukee Breastfeeding Coalition, established Lake County Breastfeeding Coalition, and participated in Breastfeeding Coalitions in Manistee, Mason, Mecosta, and Newaygo counties.
Local WIC authorized grocery stores, pharmacies, and our communities benefited from over $5.6 million in WIC food sales.
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Essential Local Public Health Services
Includes eight fundamental public health services mandated in Part 24 of the
Public Health Code, Public Act 368.
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Oceana Wexford Total
Onsite Sewage
Septic Permits 63 98 100 121 95 138 45 183 139 86 1,068
Septic Failures 37 22 6 37 44 56 12 73 42 46 375
Water Program
Well Permits 75 109 123 133 132 188 88 206 149 109 1,312
Well Inspections 41 58 66 35 48 51 18 21 32 15 385
Food Service
Food Operation
Inspections 115 113 86 208 262 269 75 353 215 315 2,011
Temp Food Booth 14 18 53 69 76 106 37 46 87 109 615
Reported Food Borne 0 2 2 4 1 9 3 5 0 8 34
Immunizations
Vaccines Given 1,370 967 480 2,309 3,391 2,252 923 1,410 1,835 2,102 17,039
Influenza Vaccines 737 1,498 653 1,591 1,606 1,348 973 1,733 1,602 1,813 13,554
Communicable Disease
TB Skin Tests Given 73 143 44 264 331 204 119 189 155 317 1,839
TB Patients on 1 2 0 4 6 1 0 4 42 5 65
Communicable Disease 281 152 76 235 117 480 165 268 170 566 2,510
STD Services
STD Services 87 59 27 58 19 125 51 154 0 136 716
HIV Tests 4 8 0 8 14 5 16 25 13 29 122
Hearing Screenings
Preschool Hearing 225 358 117 128 328 258 314 562 321 538 3,149
School Hearing 280 311 134 732 1,098 1,485 374 2,078 755 1,044 8,291
Vision Screenings
Preschool Vision 182 285 122 121 322 282 246 571 323 444 2,898
School Vision Screenings 625 826 328 1,239 1,863 2,574 871 4,282 1,489 2,062 16,159
16
Health Care Access
Provides services and links to needed services for at-risk populations.
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Oceana Wexford Total
Maternal Infant Health Program (MIHP)
# of Maternal
Clients 64 68 54 66 101 146 78 169 115 164 1,025
# of Maternal
Visits 539 505 309 434 588 801 600 1,085 715 1,368 6,944
# of Infant
Clients 60 48 31 60 57 114 64 126 74 140 774
# of Infant
Visits 688 598 202 670 632 950 837 1,081 546 1,378 7,582
Children’s Special Health Care Service
# of Children 50 81 27 60 93 166 58 177 94 176 982
# of Service 133 192 69 162 160 414 104 365 168 1,141 2,908
Women, Infants, and Children (WIC)
Average
Monthly
Enrollment
424 567 324 578 1,036 1,330 331 2,137 1,248 1,617 9,592
% Return Rate 92% 93% 93% 90% 93% 92% 93% 93% 93% 91% 92%
# of Project
Fresh Books
Distributed
113 192 111 167 320 340 81 1,095 360 448 3,227
$ Value of
Project Fresh
Coupons
$2,260 $3,840 $2,220 $3,340 $6,400 $6,800 $1,620 $21,900 $7,200 $8,960 $64,540
Child Lead
Screening 55 55 52 56 91 202 47 279 170 266 1,273
Family Planning Services
# of Clients
Served 173 155 38 314 565 162 197 369 337 579 2,889
17
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Oceana Wexford Total
WiseWoman Program
# Screened 84 92 91 124 186 172 59 218 140 218 1,384
# Referred 58 73 73 80 127 114 38 123 83 143 912
# Counseled 171 188 176 293 295 467 117 538 283 453 2,981
Breast and Cervical Cancer Control Program (BCCCP)
# of Women
Screened 100 98 111 133 207 182 67 244 172 230 1,544
# Breast
Cancer Found 3 1 0 1 2 3 4 8 2 1 25
# Cervical
Cancer Found 2 1 2 2 2 0 1 5 3 2 20
Colorectal Cancer Screening Program
# Screened 15 24 27 53 56 56 14 62 44 42 393
# High Risk
Referrals 0 4 0 4 5 4 0 2 6 2 27
# Pre-
cancerous
polyps/cancer
0 2/1 0 2 2 2 0 0 2 0 10/1
Dental Health - services provided in partnership with Michigan Community Dental Clinics
# Clinic Clients 616 1,395 277 1,676 1,971 1,869 845 401 2,563 2,977 14,590
Tencon Program
Health Plan
Enrollments 268 234 217 263 312 335 196 428 364 432 3,049
Prescription
Drug
Coverage
Enrollments
102 52 65 119 132 120 21 160 119 120 1,010
Medicaid Application Assistance
# Served 53 47 100 126 384 119 146 58 394 1,396 2,823
Health Care Access, Continued
18
Environmental Health Services by County
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Total Oceana Wexford
Radon Kits
Distributed 52 7 50 91 92 143 98 46 923 60 284
Soil
Evaluations 1 6 0 8 5 8 2 13 47 3 1
Mortgage
Evaluations 0 2 2 61 12 18 1 126 250 26 2
Building
Permit
Approvals
2 86 24 9 19 34 5 30 263 52 2
Complaints
(all) 17 18 7 9 46 26 3 71 256 23 36
Child Care
Inspections 9 34 8 21 19 26 8 51 237 23 38
Campground
Inspections 32 11 29 24 24 24 14 37 260 37 28
Swimming
Pool
Inspections
5 6 1 21 53 19 0 10 165 35 15
Type II
Sanitary
Surveys
10 31 11 2 11 36 21 32 201 18 29
Tanning
Inspections 4 4 3 6 6 4 2 13 57 6 9
Animal
bites/
exposure
15 7 6 15 15 20 8 15 13 16 130
19
Community Health Indicators
Crawford Kalkaska Lake Manistee Mason Mecosta Missaukee Newaygo Oceana Wexford Michigan
Total
Population 14,074 17,153 11,539 24,733 28,705 42,798 14,849 48,460 26,570 32,735 9,883,640
Number of
Births 134 193 111 203 295 460 181 570 339 400 117,309
Birth Rate
(per 1,000) 9.4 11.4 10.2 8.3 10.3 11.0 12.2 11.7 12.3 12.7 11.8
Number of
Deaths 149 154 142 283 283 317 149 461 247 295 86,310
Death Rate
(per 100,000) 10.5 9.1 13.0 11.6 9.9 7.6 10.0 9.5 9.0 9.3 8.7
Cancer
Mortality
Age Adjusted Rate
per 100,000
199.1 223.6 233.1 198.1 168.0 157.3 182.1 196.6 164.3 168.9 184.8
Cardiovascular
Disease
Mortality
Age Adjusted Rate
per 100,000
253.1 241.9 263.0 241.1 244.3 255.2 333.9 250.0 268.3 253.6 276.2
Median
Household
Income
$35,866 $40,052 $29,373 $41,067 $38,073 $37,840 $38,657 $39,059 $37,655 $38,587 $45,254
Persons below
Poverty 19.2% 16.7% 23.4% 13.9% 17.8% 20.9% 15.0% 18.6% 20.6% 17.0% 16.1%
Medicaid
Covered Births 70.1% 63.7% 70.3% 55.2% 58.3% 56.1% 47.0% 56.1% 68.4% 53.0% 44.0%
Teen Pregnancy
Rate per 1,000 64.8 68.2 68.5 54.4 55.1 32.4 56.4 61.2 75.2 63.1 53.6
Smoked while
Pregnant 45.5% 35.8% 35.1% 39.9% 26.4% 32.4% 26.0% 26.8% 20.1% 30.3% 18.2%
Data Source: Michigan Department of Community
Health and US Census Bureau
20
DHD#10 Office Directory
Crawford County
202 Meadows Drive
Grayling, MI 49738
989 348-7800
Kalkaska County
625 Courthouse Drive
Kalkaska, MI 49646
231 258-8669
Lake County
5681 S M-37
Baldwin, MI 49304
231 745-4663
Manistee County
385 Third Street
Manistee, MI 49660
231 723-3595
Mason County
916 Diana Street
Ludington, MI 49431
231 845-7381
Mecosta County
14485 Northland Drive
Big Rapids, MI 49307
231 592-0130
Missaukee County
6180 W Sanborn, Suite #1
Lake City, MI 49651
231 839-7167
Newaygo County
1049 Newell Street
White Cloud, MI 49349
231 689-7300
Oceana County
3986 N Oceana Drive
Hart, MI 49420
231 873-2193
Wexford County
521 Cobbs Street
Cadillac, MI 49601
231 775-9942
Community Partners
0-5 Parents as Teachers Grant, Newaygo County
Airway Oxygen in Cadillac
Cadillac Area Public Schools
Cadillac Family Physicians
Cadillac Family Practice
Cadillac Rotary
Dynamic Physical Therapy
Early on Program: Manistee, Crawford, and Newaygo counties
Evergreen Physical Therapy
Fremont Area Community Foundation
Fremont Christian Church
General Mills
Great Lakes People Fund
Great Parents/Great Start, Manistee, Mason, Lake, Oceana, and Newaygo counties
Ice Mountain
Lake City Family Dentistry
Lake County Children’s Trust Fund
Lake County Community Foundation
Magna Mirrors
Manistee County Community Foundation
Manton Consolidated Schools
Manton Rotary
Mason County Community Foundation
MC Sports
Meceola Children’s Council
Mecosta County Community Foundation
Mecosta County Medical Center
Mercy Hospital Cadillac
Mesick Consolidated Schools
Michigan Hearing Systems
Oceana Intermediate School District
Peacock Industries
Pentwater Junior Women’s Club
Three Generations Circle of Women Givers
United Way of Mason County
United Way of Northwest Michigan
United Way of the Lakeshore
Visit Us Online at
www.dhd10.org