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Kandiyohi County Public Health - 2010
Disease Prevention and Control
Some people call them immunizations. Others call them vaccinations or shots. Whatever you call them, immunizations are one of the best weapons we have against a number of serious diseases.
Health Services Participants Served
Mantouxs (at KCPH Office - Contracted Services) 2003 2004 2005 2006 2007 2008 2009 2010 61 49 105 56 83 42 20 55 Mantoux (Worksite – Dental Office Contract) 17 Blood Pressure Walk-ins 2003 2004 2005 2006 2007 2008 2009 2010 18 16 23 23 10 15 29 34 Blood Pressure Screenings at Community Clinics 2003 2004 2005 2006 2007 2008 2009 2010 259 208 150 120 174 211 251 211
Immunizations 2002 2003 2004 2005 2006 2007 2008 2009 2010
Clinic Clients* - Regularly scheduled monthly clinics 587 567 648 482 431 350 382 368 337 Vaccine Doses 983 976 1,096 884 846 698 697 689 664 Number of Walk-In Clients* 172 152 165 215*** 30 28 23 School/other community clinic vaccinations* 657 705 96 157 57 56 59 Refugee Vaccinations** 201 216 166 193 220 Billed 156 151 Non-billed 37 69 *Duplicated number **Duplicated number of refugees that came in for immunizations as walk-in or on Fridays for appointments ***Walk-ins for 2007 may include late 2006 flu season clients from January and February 2007)
Immunizations - Influenza
2002 2003 2004 2005 2006 2007 2008 2009 2010 Seasonal Flu Vaccinations 1,693 1,485 13* 1,559 1,379 1,444 1,552 1,528 2,295 (Late 2006 season given in February 2007) 318 Seasonal Worksite Clinic Vaccinations 1,319 Seasonal School Clinics Vaccinations 886 Regularly Scheduled Clinics 90
H1N1 Vaccinations (not included in seasonal) 1,840 1,540 (total school located clinic doses 2,123—1,765 first doses, 358 second doses)
Total Flu Vaccines Given 3,368 3,835 *In 2004, Homeland Health Clinics held due to shortage of vaccine and severity of Influenza Disease: 870 vaccinations given. KCPH distributed its vaccine to local medical clinics, Rice Memorial Hospital, assisted living facilities, home care agencies and nursing homes.
Latent TB Infections TB Disease Follow-up
2002 2003 2004 2005 2006 2007 2008 2009 2010
Clients* 14 9 25 39 89 124 81 66 121
Visits 296 154 88 216 578 624 303 254 1,040
Clients/Latent TB Infection * 36 88 122 81 65 117 LTBI Visits 285 476 303 246 568 New LTBI Clients 41 35 79
Active TB: MDH TB Cases by County
Clients 1 1 0 3 1 2 0 1 4 2005: 2-pulmonary, 1-Extrapulmonary
Active TB Visits 293 148 0 8 470 New TB Clients 3
*May have also been clients in the prior year
Latent TB Activity Summary 78 new LTBI starts in 2010
64 people received or completed their meds. Most of them within 9 months. 82 % completion.
3 moved and had interjurisdictional referrals made to other states.
10 lost/uncooperative. 7 were uncooperative and 3 of them moved with no forwarding address.
One person started late in the year and restarted meds.
Primary Refugee Arrivals in Kandiyohi County
2002 2003 2004 2005 2006 2007 2008 2009*
Kandiyohi 2 4 19 25 63 29 3 10 Minnesota 1035 2403 7345 5323 5354 2867 1205 1265
Kenya 1
Cuba 2 3 1 1
Ethiopia 3
Somalia 1 2 19 22 60 28 3 9
* Most current information from the Minnesota Department of Health Refugee Health
Program
Environmental Health
Environmental Health — Touching Everyone’s Life Every Day Environmental health is an integral part of Minnesota's public health system. Events in the last several years, including natural and manmade disasters, terrorism, and food borne disease outbreaks, have demonstrated this again and again.
Food, Beverage, Lodging and Tobacco Activities
2004 2005 2006 2007 2008 2009 2010
Inspections:
Food Beverage Lodging 249 267 267 281 300 308 301
FBL Complaints 16 8 8 12 9
Required enforcement action 8 6 2 4 5
Food, Beverage, Lodging and Tobacco Activities
Public health nuisance complaint
2004 2005 2006 2007 2008 2009 2010
6 11 13 8 5 3 2
Required enforcement action
2004 2005 2006 2007 2008 2009 2010
3 0 3 2 1 0 0
Food, Beverage, Lodging and Tobacco Activities
Licensed tobacco retailers
2004 2005 2006 2007 2008 2009 2010
56 50 47 45 37 37 36
Sales to minors through regular compliance checks
2004 2005 2006 2007 2008 2009 2010
9 9 11 10 1 3 4
Compliance Check Failure Rate
2004 2005 2006 2007 2008 2009 2010
16% 21% 23% 26% 3% 8% 11%
Food, Beverage, Lodging Inspections
2001 2002* 2003 2004 2005 2006 2007 2008 2009 2010 Total Inspections 143 248 255 259 280 282 281 300 308 301 Violations 1762 2037 1417 1182 1213 949 820 880 1173 985 Critical Violations 525 782 574 648 447 350 303 294 332 279 Average # of violations per inspection 12.32 8.21 5.55 4.56 4.33 3.36 2.91 2.93 3.80 3.27 Average # Criticals 3.67 3.15 2.25 2.50 1.59 1.24 1.07 .98 1.07 .92
Food, Beverage, Lodging Licensing
2003 2004 2005 2006 2007 2008 2009 2010 Food and Beverage
164 165 170 174 176 182 179 179
Temporary Facilities
107 103 112 126 132 161 143 150
Food Vending Machines
247 242 242 218 223 241 216 210
Lodging
45 47 46 49 49 55 54 51
MHP, Rec-Camping Areas
32 31 30 29 30 31 31 31
Pools
7 8 8 8 11 13 15 14
Family Health Home visitation has been an effective strategy for the delivery of public health services to families for more than a century. Current research shows that Public Health Nurse (PHN) home visitation, especially for pregnant women and families with young children, is effective at helping families improve health status, achieve economic self-sufficiency, improve positive parenting, reduce child maltreatment, reduce juvenile delinquency, achieve maternal goals such as child spacing, education and employment, and establish links to community resources.
Family Health Referrals
Reason for Referral 2005 2006 2007 2008 2009 2010
Prenatal 515 369 363 327 208 200
Prenatal High Risk NA 189 169 213 256 293
Postpartum 538 571 598 540 514 519
Lice 9 2 3 7 0 2
PCA 56 64 78 60 49 58
Lead 25 15 15 17 5 6
MCH 45 32 24 9 4 1
MCSHN NA NA 3 4 2 0
FHV NA NA 16 32 22 41
Perinatal Hep B NA NA NA 2 3 3
Mental Health NA NA NA NA NA 5
Total MCH Referrals 1,128
Prenatal 2002 2003 2004 2005 2006 2007 2008 2009 2010 Clients 291 251 265 216 136 80 74 226 303 High Risk Pregnancy Clients 31 Prenatal Universal Contact Clients 90 Prenatal WIC Clients 217
Visits 209 190 226 205 146 77 60 271 380 Office 59 Home 160 High Risk Pregnancy-home 37 Prenatal Universal Contact-home 117 Prenatal WIC Visit-office 226
0
100
200
300
400
2002 2003 2004 2005 2006 2007 2008 2009 2010
Cl i e nt s
Vi si t s
Postpartum
2002 2003 2004 2005 2006 2007 2008 2009 2010
Clients 525 468 410 358 361 336 287 259 242
Visits 578 517 479 424 359 312 336 295 243
0
100
200
300
400
500
600
2002 2003 2004 2005 2006 2007 2008 2009 2010
C lients Visits
Family Home Visiting
2002 2003 2004 2005 2006 2007 2008 2009 2010
Clients 143 117 144 158 95 92 100 112 88
Visits 344 416 368 279 255 170 328 362 349
0
100
200
300
400
500
2002 2003 2004 2005 2006 2007 2008 2009
C lients Visits
Family Home Visiting High Risk Children (includes TANF)
2005 2006 2007 2008 2009 2010 Clients 44 20 17 42 33 41
Visits 84 43 32 165 145 142
0
50
100
150
200
2005 2006 2007 2008 2009 2010
C lients Visits
Minnesota Family Investment Program (MFIP)
MFIP Classes are taught by Public Health at the WorkForce Center
2008 2009 2010*
Participants 105 93 50 The Minnesota Family Investment Program, or MFIP, is the state’s welfare reform program for low-income families with children. MFIP helps families move to work and focuses on helping families. It includes both cash and food assistance. When most families first apply for cash assistance, they will participate in the Diversionary Work Program, or DWP. This is a four month program that helps parents go immediately to work rather than receive welfare.
*2010: 10 months served – no class in March and August
Incredible Years Classes
2006 2007 2008 2009 2010
Participants 47 49 65 55 114
11 classes
The Incredible Years Parents, Teachers, and Children Training Series has two long-range goals.
*The first goal is to develop comprehensive treatment programs for young children with early onset conduct problems.
*The second goal is the development of cost-effective, community-based, universal prevention programs that all families and teachers of young children can use to promote social competence and to prevent children from developing conduct problems in the first place.
Expectant Parent Classes
Number of Pregnant Women Registered
2002 2003 2004 2005 2006 2007 2008 2009 2010 87 92 71 74 90 87 62 58 82
Breastfeeding Class 2010
Attendees 49
WIC
Average # participants/month 2002 2003 2004 2005 2006 2007 2008 2009 2010 1,440 1,597 1,726 1,780 1,840 1,842 1,839 1,835 1,792
Highest Month 2002 2003 2004 2005 2006 2007 2008 2009 2010 Nov July Sept Aug July July Oct Oct May
1,534 1,670 1,780 1,835 1,909 1,919 1,931 1,904 1,820
Second Highest Month August Sept Nov August
1,915 1,884 1,874 1,819 2005 2006 2007 2008 2009 2010
Regular workday: (approx.) 30 67 47 48 55 50 Extended workday: (approx.) 60-70 78 63 65 69 64 (Occurs 2 days per month)
Child and Teen Checkups
Participation Outcome Ratio Indicator Points
10/2008 – 10/2009 71
10/2007 – 10/2008 71 74.0
10/2006 – 10/2007 69 66.0
10/2005 – 10/2006 66 57.0
10/2004 – 10/2005 68 73.0
10/2003 – 9/2004 66 70.0
10/2002 – 9/2003 61 73.0
10/2001 – 9/2002 64
Lead Referrals
Children who have been referred to Public Health for High Lead
2004 2005 2006 2007 2008 2009 2010
22 25 40 14 17 5 6
Referrals were from:
MDH 36 12 17 5
ACMC 3 2 0
Mid MN 1
Follow Along
Active Children
2002 2003 2004 2005 2006 2007 2008 2009 2010
254 229 220 167 154 202 217 248 258
The screening is a brief, simple procedure used to identify potential health, developmental, or social-emotional problems in infants and young children in the context of family, community, and culture who may need a health assessment, diagnostic assessment, or educational evaluation.
Provides an opportunity for young children and their families to access a wide variety of services and early childhood programs; and Promotes and supports parents’ understanding of their child’s health, development, and learning.
Health Promotion
Promotes, encourages and supports healthy and safe communities, and works to build capacity for individual, community and system change to improve health and prevent injury, substance abuse and chronic disease.
Statewide Health Improvement Program (SHIP)
The goal of SHIP is to help Minnesotans live longer, healthier, better lives by preventing risk factors that lead to chronic disease including tobacco use and exposure, physical inactivity and poor nutrition.
It is an integral component of an overall health care reform initiative passed during the 2008 Legislative session.
Kandiyohi County SHIP Interventions
Community Implement tobacco-free policies for parks, playgrounds, beaches, fairs, and other
recreational settings. ~ Review and update current tobacco-free policies, and create policies for other
areas assisted. ~ Assisted City of Willmar with their tobacco-free policy update.
Implement policies/practices that create active communities by increasing opportunities for walking and biking. ~ Establish ‘Walkable’ communities and work on trails: identification, promotion,
connections and maintenance. Implement policies/practices, and environmental changes that improve access to
nutritious foods: require calorie or nutrition labeling on menus and facilitate the development of new farmer's markets and promote their use. ~ Promote Farmer’s Markets and community gardens, and initiate voluntary menu
labeling in food serving establishments. ~ McMillian’s Healthy Heart Menu.
Implement policies and practices that support healthy eating and physical activity in licensed child care and pre-school settings.
~ Site assessments, mini-grants that support healthy eating and physical activity. ~ Provide trainings for ECFE, childcare centers, and in-home childcares.
SHIP Interventions continued School
Implement policies/practices that create active schools by increasing opportunities for walking and biking to-and-from school and access to school recreation facilities.
~ Safe Routes to School, Walking School Bus or Riding Bike Train
~ Walking audit around Willmar Middle School
Implement comprehensive nutrition policies: healthy lunch and snacks - including concessions and Farm-to-School initiatives.
~ Willmar Public Schools: Farm to school
~ NL-S: Healthy lunch and snacks, farm to school
~ Community Christian School: Healthy lunches
SHIP Interventions continued
Healthcare Develop relationships with/among health care providers to facilitate
active referral of patients to local resources that increase access to high quality nutritious foods and opportunities for physical activity.
~ Support Diabetes Prevention Programs currently
implemented through the YMCA, plan and
implement referral program through WIC and local
health care providers for families with children that
are overweight or at risk for overweight.
~ Update information on MinnnesotaHelp.org
Worksite Implement policies/practices that support increased consumption of
fruits and vegetables and other nutritious foods: healthy food service and catering options, and healthy vending.
~ Contract with Blue Cross Blue Shield for
“Healthy Eating at Work” initiative.
SHIP Interventions continued
Farm to School program
WPS Wellness Policy Committee
Update to Willmar’s Tobacco Policy
McMillian’s Healthy Heart Menu
“Willmar Walks” map of downtown Willmar and markers placed
2010 Successes in Steps and SHIP
The Kandiyohi County Drug Free Communities (DFC) Coalition was awarded a Drug Free Communities Grant from the Federal Government on September 29, 2009. The award is in the amount of $125,000 for up to five years with the opportunity to re-apply for five more years, for a total of 10 years.
The KC DFC Coalition has two main goals.
1. To reduce substance use/abuse in Kandiyohi County
2. Build and strengthen the capacity of the coalition
Our mission Statement:
“The Kandiyohi County Drug Free Communities Coalition is working together to empower the community through prevention, education and shared leadership to reduce alcohol, tobacco and illegal drug use among our youth and families”.
Accomplishments in Year One (2009-2010)
Nov: R. Moldenhauer Energy Drink Presentation
March: Town Hall Meeting on Underage Alcohol Use
April: Alcohol Awareness Month Campaign
April/May: Prom & Graduation Campaign
May-Dec: Underage Drinking Media Campaign
July: Merged KC ATOD & KC Tobacco Coalitions
August: Announce New Name: KC DFC Coalition
Sept: Assist New London w/passing Social Host Ordin.
Child Passenger Safety Seats
Child Passenger Safety Seats Checked at Clinics 2002 2003 2004 2005 2006 2007 2008 2009 2010
79 33 61 42 44 42 56 42 35 UCare Seats Distributed 41 57 27 Foster/Daycare Providers Taught 34 21 27 Expectant Parent Class Participants Taught 92 82 AAA Grant Booster Seats Distributed 23 0 MN Boosters (from MN Office of Traffic Safety) 10 21
0
20
40
60
80
2002 2003 2004 2005 2006 2007 2008 2009 2010
Number of CPS Seats checked at Clinics
Chronic Disease Prevention
Efforts to reduce the burden of suffering and death from chronic diseases and injuries in Minnesota, by providing leadership in the prevention of chronic diseases and injuries, conducting public health surveillance, and developing, implementing, evaluating and supporting public health interventions.
PCA Assessments Personal Care Assistant
2002 2003 2004 2005 2006 2007 2008 2009 2010 PCA Assessments (Face to Face) 32 60 104 117 152 186 180 178 178 Visits 33 71 96 121 158 198 178 188 224 PCA Service Plan Change Clients 5 Visits 4
0
50
100
150
200
250
2002 2003 2004 2005 2006 2007 2008 2009 2010
C lients Visits
Care Coordination Services
2004 2005 2006 2007 2008 2009 2010 Number of clients
Community Alternative Care 2 3 3 5 5 5 5 Community Alternative for Disabled Individuals 81 71 66 33 52 46 48 Traumatic Brain Injury 27 24 30 20 17 15 15 MSHO/MSC+ NA 44 298 385 361 337 302 MR/DD 47 48 36 23 12 8 5 Screenings/RSC 222 169 122 147 126 144 144
Jail 2002 2003 2004 2005 2006 2007 2008 2009 2010
Clients
581 606 630 698 830 714 682 613 648
Visits
1,624 1,589 1,848 2,114 3,234* 2,639* 2,313* 1,865* 1,991*
Hours
1,529 1,794 1,805 2,756 5,250 5,178 4,632 3,433 3,711.25
Direct Care Hours 2,141 3,168 3,127 2,731 2,426 2,942.75
Indirect Staff Hours 614 2,081 2,052 1,901 1,007 768.50 *includes indirect initial assessment, may not have received a face-to-face visit.
Prairie Lakes Youth Programs
2006* 2007 2008 2009 2010
Residents 98 141 128 133 121
Visits 245 239 272
Hours 113.25 296.50 324.75 297.25 418.50
Direct Care Hours 97.50 253.50 240.50 248.75 308.00
Indirect Staff Hours 15.75 43 84.25 48.50 110.50
*Contract began July 1, 2006
Prairie Lakes Youth Programs Group Homes*
Added Boys Dec. 2004
2002 2003 2004 2005 2006 2007 2008 2009 2010
Hours 4 29.25 40.00 43.50 70.50 51.00 60.50 67.75 60
Boys (hours) 3.75 21.50 22.75 23.50 32.50 25.50 31
Girls (hours) 4 29.25 36.25 22.00 47.75 27.50 28.00 27.25 29
Includes Staff Training (CPR and Medication Administration) and Health Inspections by an RN (1 time per month)
Group home contract began July 1, 2006, prior to contract, group homes were administered by Kandiyohi County
Medication Administration Classes
2007 2008 2009 2010 Kandiyohi County Jail 74 53 50 50 Prairie Lakes Youth Programs 31 14 55
Agency FTEs
2000 28.96 FTEs 60,236 hours
2001 27.93 FTEs 58,094 hours
2002 28.28 FTEs 58,822 hours
2003 27.38 FTEs 56,950 hours
2004 27.15 FTEs 56,472 hours
2005 28.73 FTEs 59,758 hours
2006 29.68 FTEs 61,734 hours
2007 29.78 FTEs 61,942 hours
2008 30.30 FTEs 63,024 hours
2009 29.72 FTEs 61,817 hours
2010 30.58 FTEs 63,605.13 hours
1 FTE = 40 hour work week
Agency Expenditures
2000 $1,455,447 2001 $1,858,144 2002 $1,688,709 2003 $1,896,211 2004 $1,813,782 2005 $1,986,459 2006 $2,182,978 2007 $2,220,529 2008 $2,360,588 2009 $2,348,315
2010 Budget $2,411,100 2010 Actual Expenditures $2,537,040
Revenue Sources 2010
Contracts, $366,937.73 ,
14%
Insurance, $423,995.53 ,
17%
County Taxes,
$439,809.74 , 17%
CHS Subsidy,
$182,500.00 , 7%
Fees, $147,638.43 , 6%
Grants, $976,158.62 ,
39%
Revenue Sources 2010
Grants, $976,158.62 ,
39%
Fees, $147,638.43 , 6%
CHS Subsidy,
$182,500.00 , 7%
County Taxes,
$439,809.74 , 17%Insurance, $423,995.53 ,
17%
Contracts, $366,937.73 ,
14%
Revenue Sources 2009
Grants, $850,957.88 ,
37%
Fees, $160,449.09 , 7%
CHS Subsidy,
$182,501.00 , 8%
County Taxes,
$339,916.59 , 14%Insurance, $451,238.53 ,
19%
Contracts, $363,252.32 ,
15%
Kandiyohi County Public Health 2010
Expenditures YTD % Budget
Personnel $2,153,333.32 102% $2,119,600
Travel $9,496.34 91% $10,400
Family Health $358.33 119% $300
Disease Prevention & Control $21,480.98 77% $27,900
Health Promotion $56.12 28% $200
Environmental Health $9,258.98 65% $14,300
Child & Teen Checkups $31,520.55 261% $12,100
Administration $88,913.56 93% $95,500
Emergency Preparedness $13,102.93 624% $2,100
Maternal Child Health $11,259.84 93% $12,100
WIC $22,532.89 410% $5,500
One Time Grants $19,580.21 % $0
Tobacco Compliance Checks $316.05 105% $300
Tobacco Endowment $15,000.00 100% $15,000
TANF $28,234.00 114% $24,700
Coalition for Healthy Adolescent Sexuality $2.37 % $0
Steps to a HealthierUs Willmar $18,562.01 159% $11,700
Statewide Health Improvement Plan SHIP $52,541.57 88% $60,000
Drug Free Communities DFC $41,480.00 % $60,000
452/5830 Miscellaneous $10.00
Total Revenues $2,097,240.31 110% $1,914,200.00
Total Expenditures $2,537,040.05 105% $2,411,700
Net -$439,809.74 % -$497,500.00
Kandiyohi County Public Health 2010
Revenues YTD % Budget
Licenses: Food, Beverage, Lodging $84,283.00 111% $76,000
Tobacco License Fees $9,525.00 125% $7,600
MA/Waiver Services ( $144,598.52 80% $180,000
Immunizations $4,353.84 198% $2,200
Prenatal $420.87 421% $100
Child and Teen Checkups Contract $133,623.14 105% $127,300
Mantoux $121.57 61% $200
Community Health Plan $182,500.00 100% $182,500
One-Time State Grants $275.00 $0
Foreign Borne/TB Disparities $3,579.00 97% $3,700
Statewide Hlth Imprvmnt Plan SHIP $213,499.98 100% $213,500
WIC $298,605.00 122% $245,000
Steps-Healthier MN $18,000.00 78% $23,000
Drug Free Communities $127,107.31 $0
Immunization Grant #93268 $8,569.66 87% $9,800
Emergency Preparedness $111,671.36 331% $33,700
TANF #93558 $46,275.08 75% $61,300
MCH Grant #93994 $53,143.00 101% $52,500
MSHO/FS Case Management $179,129.03 85% $210,000
Vision/Hearing/Preschool Screening $4,992.00 56% $8,900
Insurance & PMAP Health Plans $100,267.98 100% $100,000
Prenatal and Incredible Years Classes $4,699.33 94% $5,000
Kandiyohi County Public Health 2010
Revenues (Continued) YTD % Budget Mantoux $662.60 166% $400 Jail $170,473.92 99% $171,600 Immunization Registry $1,242.25 21% $6,000 Immunizations $38,040.21 62% $61,200 Long Term Care Consultations/screenings $39,101.02 95% $41,000 Health Promotion Fees $4,160.50 104% $4,000 PACT 4- Universal Contact $36,000.00 100% $36,000 PACT 4- Share $8,643.21 309% $2,800 PACT 4- Family Home Visiting $29,954.49 100% $30,000 PACT 4- School Nurse Contract $2,735.90 $0 Follow Along Early Intervention $3,899.00 100% $3,900 Prairie Lakes Youth Programs $14,769.50 98% $15,000 MDH Health Disparities $1,826.76 $0 Donations $20.00 $0 Child Safety Donations $90.01 $0 One Time Local grants $15,109.77 $0 Transfer Capital Equipment $1,251.50 $0 $2,097,220.31 110% $1,914,200 452/5830 Miscellaneous $10.00 $2,097,230.31 Actual Budgeted Total Revenues $2,097,230.31 110%$ $1,914,200.00 Total Expenditures $2,537,040.05 105% $2,411,700.00 Net -$439,809.74 -$497,500.00