HomeMy WebLinkAbout2017 Communicable Disease Performance Measures-PlannedJefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[1]
PROGRAMS: Tuberculosis, Communicable Disease (CD), Immunizations, Travelers Immunizations, Sexually Transmitted Disease, HIV, Syringe Exchange Program
MISSION: The purpose of the Communicable Disease Health program is to protect Jefferson County residents from serious communicable diseases by providing disease
surveillance, investigation and reporting, along with education, screening, treatment and immunization services. The program interacts with community members, medical
providers, the Washington State Department of Health (DOH), Region 2 Emergency Management partners and other agencies while working toward this purpose.
Goals Objectives Performance Indicators 2012 2013 2014 2015 2016
Projected
2017
Planned
Goal 1:
Maintain the low
rates of active
Tuberculosis (TB)
in Jefferson County
Encourage appropriate
screening and treatment for
latent TB infection.
Number of clients tested for TB
infection with PPD or QFT test 198 165 149 148 160 148
Number of positive PPD and QFT TB
tests evaluated +PPD: 0 +PPD: 3 +PPD: 2 +PPD: 2 +PPD: 2 +PPD: 2
Number of clients started on preventive
treatment for latent TB infection 2 1 2 1 2 1
Goal 2:
Timely investigation
of reportable
conditions.
Develop & update protocols
and forms as needed for
investigation of notifiable
conditions using DOH
electronic reporting systems
PHIMS, PHIMS-STD, and
PHRED.
Total number of communicable disease
reports confirmed, interventions applied
and processed for reporting to the State
150 143 180
(21
gonorrhea)
201
(42
pertussis)
160 160
Total number of STD cases reported to
the State 57 83 103 69 80 80
Number of chlamydia cases reported to
the State: female, male, total
Fe: 36
M: 13
T: 49
Fe: 68
M: 13
T: 81
Fe: 59
M: 18
T: 77
Fe: 42
M: 15
T: 57
60 60
Number of gonorrhea cases reported to
the State: female, male, total
Fe: 0
M: 1
T: 1
Fe: 2
M: 1
T: 3
Fe: 13
M: 8
T: 21
Fe: 5
M: 4
T: 9
9 9
Goal 3:
Inform medical
providers about
current CD trends
and new CD control
recommendations.
Provide updates, outreach and
training to providers about
local, state and national CD
outbreaks and disease control
recommendations. Provide
reminders about reporting
notifiable conditions and
using the after-hours reporting
number.
Number of alerts/updates/newsletters
faxed, emailed, or mailed to providers
(not including DOH Influenza Updates)
14 15 23 8 15 15
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[2]
Goals Objectives Performance Indicators 2012 2013 2014 2015 2016
Projected
2017
Planned
Goal 4:
Work with local
clinics and DOH to
support universal
access to vaccines
for all children
through the federal
and state funded
Vaccines for
Children Program
(VFC).
Maintain an efficient system
for supplying vaccine
recommendations, and VFC
program up-dates, to VFC
provider clinics in Jefferson
County. Monitor VFC vaccine
usage in Jefferson County.
Total number of doses of VFC vaccine
(all pediatric), administered by private
providers and JCPH clinics, supplied
and monitored through JCPH
immunization program
5,403 5,067 4613 4724 4800 4800
Number & percent of doses of VFC
vaccine administered by private health
care providers
4,855
89.9%
4,545
89.7%
3967
86%
4222
89.4%
4160
87%
4160
87%
Number & percent of doses of VFC
vaccine administered by JCPH
548
10.1%
522
10.3%
646
14%
502
10.6%
640
13%
640
13%
Goal 5:
Assure quality of
immunization
services in clinics
providing VFC
vaccines, as required
by DOH.
Perform vaccine quality
assurance visits for 50% of
clinics annually. Assess
childhood immunization rate
for pediatric patients in 25%
of clinics annually.
Number of clinics visited for VFC
Program Quality Assessment and/or to
assess childhood immunization rates in
clinic patients.
2 2
2
+ 1 visit
by DOH
Total =
3 clinics
2
+ 1 visit
by DOH
Total =
3 clinics
2
+ 1 visit
by DOH
Total =
3 clinics
2
+ 1 visit
by DOH
Total =
3 clinics
Goal 6:
Promote more
extensive use of all
Washington State
Immunization
Information System
(WAIIS) functions
by the provider
clinics.
Continue to provide training
and support to provider clinics
for use of all WAIIS vaccine
related functions to accurately
and efficiently track vaccine
supply, administration, and
client records. Train on new
modules as they become
available.
Number of clinics using WAIIS to order
vaccine, track monthly vaccine
inventory, and track monthly vaccine
doses administered
0 2 (40%) 4 (80%) 5 (100%) 4*
(100%) 4 (100%)
Number of clinics trained to use WAIIS
vaccine return module 0 0 0
Clinics
trained but
module not
functioning
correctly
4 (100%) 4 (100%)
*Total number of clinics decreased to four in 2015 when two Jefferson Healthcare Clinics merged into one clinic.
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[3]
Goals Objectives Performance Indicators 2012 2013 2014 2015 2016
Projected
2017
Planned
Goal 7:
Maintain access to
vaccines for
international travel,
in part to prevent
travel associated
outbreaks in
Jefferson County.
Provide travel immunization
clinics (includes all disease
prevention recommendations,
including for malaria and
other insect borne diseases).
Number of clients immunized in travel
immunization clinic:
Adults
Age 18 and under
Total
NA
Adults:
162
Adults:
140
Adults:
152
Adults:
150
Adults:
150
0 – 18 yr:
23 0 – 18 yr:
31
0 – 18 yr:
55
0 – 18 yr:
35
0 – 18 yr:
35
Total:
185
Total:
171
Total:
207
Total:
185
Total:
185
Number of private supply vaccinations
(routine and travel) administered by
JCPH (primarily for adults)
1,057 819 600 781 700 700
Goal 8:
Assess childhood
immunization rates
for Jefferson County
children.
Assess Jefferson Co.
childhood immunization rate
trends, for children seeing
Jefferson County providers,
using immunizations recorded
in WAIIS.
(Report generated by JCPH,
includes only immunizations
administered by providers in
Jefferson County. Some children
are not in the registry and some
providers in WA state don’t
participate in the registry).
Completeness of full immunization
series for children seeing Jefferson
County providers, at age 19-35 months:
4 DTaP, 3 Hep-B, 3 HIB, 1 MMR, 4 PCV, 3
Polio, 1 Var.
54%
WA =
65%
53%
WA =
71%
56%
WA =
67%
59%
WA =
NA
60% 61%
Percent of children seeing Jefferson
County providers having 1 dose of
MMR by age 19-35 months
75% 77% 81% 83% 85%
Percent of children seeing Jefferson
County providers having 4 doses of
DTaP by age 19-35 months
69% 66% 70% 72% 74%
Goal 9:
Participate in CHIP
process to assist
schools to increase
student compliance
with Washington
State immunization
requirements.
Provide training and
assistance for school
secretaries to access WAIIS
records for students. Provide
schools with immunization
information for parents. Link
schools to updated State
information on submitting
annual immunization report.
Percent of Jefferson County
kindergarten students out-of-compliance
for required immunizations, as reported
to DOH in school immunization report
each fall.
*Some schools did not report this year.
*JeffCo:
31.9%
WA:
7.5%
*JeffCo:
11.2%
WA:
10.3%
JeffCo:
21.9%
WA:
10.9%
JeffCo:
30.5%
WA:
8.6%
JeffCo:
15%
JeffCo:
10%
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[4]
Goals Objectives Performance Indicators 2012 2013 2014 2015 2016
Projected
2017
Planned
Goal 10:
The Family
Planning and STD
clinics will assist in
controlling
Chlamydia
transmission in
Jefferson County.
Women seen in Family
Planning clinic who are at
higher risk for Chlamydia (age
24 and under, CDC) will be
screened for Chlamydia
annually.
Number of female FP clinic clients age
24 and under screened for Chlamydia 301 368 320 311 320 320
Percent of female FP clinic clients age
24 and under screened for Chlamydia 56.5% 60.4% 63.4% 60.3% 62% 62%
Number of chlamydia cases reported to
the State, female, male, total
Fe: 36
M: 13
T: 49
Fe: 68
M: 13
T: 81
Fe: 59
M: 18
T: 77
Fe: 42
M: 15
T: 57
60% 60%
Goal 11:
Maintain access to
HIV testing in the
community.
Clients at high risk for HIV,
without medical insurance,
will be tested through the
State Public Health Lab,
others requesting testing will
be tested through the Quest
Lab and charged for testing.
Number of persons counseled and tested
for HIV infection
DOH
Lab:27
Quest
Lab:75
Total:
102
DOH
Lab:19
Quest
Lab:75
Total: 94
DOH
Lab:5
Quest
Lab:135
Total:
140
DOH
Lab:13
Quest
Lab:112
Total:
125
115 115
Goal 12:
Prevent the spread
of blood borne
communicable
diseases among
injecting drug users
and their partners.
Promote utilization of syringe
exchange program (SEP)
services.
Number of visits to SEP
150 185 350 238 240 240
Number of syringes exchanged 17,405 24,596 42,809 35,328 35,000 35,000
Goal 13:
Prevent fatal opioid
overdoses in
Jefferson County.
Provide overdose prevention
education to SEP clients.
Provide naloxone, for opioid
users, families and friends.
Assess and follow-up on
overdose reports.
Number of naloxone kits dispensed,
included training for proper use. New
program in 2016. NA NA NA NA
45 45
Number of opioid overdoses reported,
fatal and nonfatal, new mid-2016. NA NA
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[5]
Goals Objectives Performance Indicators 2012 2013 2014 2015 2016
Projected
2017
Planned
Goal 14:
Annual report to
BOH for CD
Programs.
Complete Annual Report Pass/Fail PASS PASS PASS PASS PASS PASS
Goal 15:
Maintain and
enhance Public
Health Emergency
Preparedness and
Response (PHEPR)
capacity.
Update regional PHEPR Plan,
coordinating with Region II
partners Clallam and Kitsap
Health Departments, local
emergency response agencies,
Jefferson Healthcare, local health
care providers and agencies.
Update Public Health Emergency
Preparedness and Response Plan 1 1 1 1 1 1
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[6]
SUMMARY OF KEY FUNDING/SERVICE ISSUES:
Communicable Disease/Immunizations
JCPH CD programs address locally identified and defined public health problems. Communicable disease prevention is primarily a locally funded
program, county millage was returned from the state to counties for TB control. Immunization funds from the state are primarily in the form of
vaccine, this vaccine is provided to primary care clinics that care for children. County funding provides professional staff that prevent, identify and
respond to disease outbreaks and immunization staff that work with the hospital, health care providers, the schools, and local groups sponsoring trips
abroad for students. Immunization staff provide routine immunization clinics and international travelers clinics. Staff respond to public requests for
information about communicable diseases and screen for reportable illnesses in the process. The CD team continues to work on strengthening the
notifiable conditions reporting system through outreach to the Jefferson Healthcare lab, ER, Infection Control Committee, and local providers.
The number of communicable diseases reported each year is difficult to predict. In the spring of 2015 there was a pertussis outbreak in the county.
The CD/Immunization team must be prepared to respond to outbreaks, by working with providers, following up with cases, making sure contacts are
identified, educated and treated as appropriate, and getting information to providers, schools and the public.
Immunizations have been identified as a Community Health Improvement Plan (CHIP) priority. The JCPH immunization team will continue to
monitor VFC vaccine usage trends in Jefferson County. This data is being affected by increasing issues within some modules of the WAIIS registry.
As a result of these issues, the reporting of the annual number of doses administered by private clinics may be inaccurate.
Due to a funding formula change, and a reduction in the number of clinics in the vaccine program after two Jefferson Healthcare clinics merged,
State/Federal funding for the Immunization Program Vaccine Accountability Contract was reduced by $3,599 for 2016. 2017 funding will be reduced
by another $743. JCPH will receive $4,006 for 2017 to complete the eight provider clinic monitoring deliverables for this contract.
JCPH will continue to be involved in the Community Health Improvement Plan Immunization Workgroup, focusing on improving immunization
rates for children and adults in Jefferson County. CHIP activities and detailed outcome indicators will be outlined in the CHIP plan and report.
The Immunization team will continue to update school secretaries’ training for using WAIIS to get immunization records for students who don’t have
a complete Certificate of Immunization Status on file. The number of students who are “out-of-compliance”, due to incomplete immunizations or
having no record of immunizations provided to the school, continues to be an issue in Jefferson County schools. JCPH will continue to work with the
schools on this issue.
STD
The Family Planning and STD clinics follow the CDC's STD testing recommendations. The Family Planning and CD program staff will continue to
monitor and explore ways to assure appropriate testing of high risk groups. The EMR program, EMDs, will continue to be assessed for the types of
data reports available.
HIV Prevention
Jefferson County Public Health – Planned Performance Measures 2017
Community Health – Communicable Disease Program
[7]
HIV/AIDS case management is provided by Clallam County Health Department for the two counties. In 2017 Kitsap County Public Health will be
applying to be the regional provider of HIV case management for Kitsap, Clallam, and Jefferson counties. CDC funding guidelines focus on
prevention programs for high risk populations, based on HIV prevalence. Jefferson County is classified as a low prevalence county, so has not had
HIV prevention funding since 2012.
The State Public Health Lab continues to do a limited number of free tests for uninsured high risk clients but there is no funding for staff time for
counseling and testing services. JCPH staff will continue to provide free HIV testing services for low income high risk clients with no medical
coverage. As more clients now have Apple Health, more tested is covered and done through Quest lab. JCPH staff will continue to provide SEP
services.
The SEP program saw an increase in client visits and the number of syringes exchanged in 2014 and 2015. For the past five years DOH has provided
a limited amount of SEP supplies to supplement our program. In 2016 JCHP has, for the first time, received 45 naloxone kits for opioid overdose
prevention through a program sponsored by the Center for Opioid Safety Education at the UW and DOH. At this time, the program does not have
funding for additional naloxone. If outside funding does not become available, JCPH will have to explore options for purchasing naloxone.
Public Health Emergency Preparedness and Response (PHEPR)
Federal funding includes developing response capacity for all hazards emergency response. Response capacity is developed in coordination with
Region 2 PHEPR partners Kitsap and Clallam Counties, local emergency response agencies, Jefferson Healthcare, and other health care providers.
Public Health staff have been trained in and use National Incident Management System protocols during communicable disease outbreaks. The roles,
responsibilities and training have been invaluable for managing communicable disease outbreaks.
Decreased funding for any program may result in scaling back on services. The Board of Health would be involved in deciding which services would
be impacted.
8/23/2016