HomeMy WebLinkAbout2018 Communicable DiseaseJefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[1]
PROGRAMS:, Communicable Disease (CD), Tuberculosis, Immunizations, Travelers Immunizations, Sexually Transmitted Disease, HIV, Syringe Exchange Program, Public
Health Emergency Preparedness
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 2013
Actual
2014
Actual
2015
Actual
2016
Actual
2017
Projected
2018
Planned
Goal 1:
Timely investigation
of notifiable
conditions.
Investigate reports of
notifiable conditions per DOH
disease specific guidelines.
Develop & update protocols
and forms as needed. Use
DOH electronic reporting
systems PHRED, PHIMS, and
PHIMS-STD, to receive
reports and send completed
reports to DOH.
Total number of communicable disease
reports confirmed, interventions applied,
and processed for reporting to the State
143 180
(21
gonorrhea)
201
(42
pertussis)
178 170 170
Total number of STD cases reported to
the State 83 103 69 73 70 70
Number of chlamydia cases reported to
the State: female, male, total
Fe: 68
M: 13
T: 81
Fe: 59
M: 18
T: 77
Fe: 42
M: 15
T: 57
Fe: 41
M: 15
T: 56
60 60
Number of gonorrhea cases reported to
the State: female, male, total
Fe: 2
M: 1
T: 3
Fe: 13
M: 8
T: 21
Fe: 5
M: 4
T: 9
Fe: 4
M: 7
T: 11
9 9
Goal 2:
Inform medical
providers about
current CD trends,
outbreaks, 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)
15 23 8 17 15 15
Goal 3:
Maintain the low
rate of active
Tuberculosis (TB)
in Jefferson County
Encourage appropriate
screening and treatment for
latent TB infection and active
TB disease.
Number of clients tested for TB
infection with PPD or QFT test;
Number of positive tests
165
3
149
2
148
2
180
1
170
1
170
1
Number of clients started on preventive
treatment for latent TB infection. 1 2 1 0 0 0
Number of cases of active TB reported 0 0 0 0 0 0
Jefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[2]
Goals Objectives Performance Indicators 2013
Actual
2014
Actual
2015
Actual
2016
Actual
2017
Projected
2018
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 publicly
funded vaccine (pediatric), administered
by private health care providers and
JCPH clinics, supplied and monitored
through JCPH immunization program
5,067 4613 4724 4627* 4700 4700
Number & percent of doses of publicly
funded vaccine (pediatric) administered
by private health care providers
4,545
89.7%
3967
86%
4222
89.4%
4198*
90.7%
4210
90%
4210
90%
Number & percent of doses of publicly
funded vaccine (pediatric) administered
by JCPH
522
10.3%
646
14%
502
10.6%
429
9.3%
490
10%
490
10%
*Issues with the reporting function of the WA State Immunization Information System (IIS) have caused errors in the monthly Doses Administered reports, therefore the number for
this report, for the Jefferson Healthcare clinics, is taken from the IIS Doses Ordered report.
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
+1 visit
by DOH
Total = 3
clinics
2
+1 visit
by DOH
Total = 3
clinics
1*
+1 visit
by DOH
Total = 2
clinics
1
+1 visit
by DOH
Total = 2
clinics
1
+1 visit
by DOH
Total = 2
clinics
*Total number of clinics decreased to four in 2015 when two Jefferson Healthcare Clinics merged into one clinic, reducing required number of clinic assessments per year.
**DOH will be piloting the Diamond Project in the first half of 2018, our program activities may change in the fall of 2018. See discussion on page 5.
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, track monthly vaccine doses
administered
2 (40%) 4 (80%) 5 (100%) 4 (100%) 4 (100%) 4 (100%)
Number of clinics trained to use WAIIS
vaccine return module 0 0
Clinics
trained but
module not
functioning
correctly.
4
(100%). 4 (100%) 4 (100%)
**DOH will be piloting the Diamond Project in the first half of 2018, our program activities may change in the fall of 2018. See discussion on page 5.
Jefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[3]
Goals Objectives Performance Indicators 2013
Actual
2014
Actual
2015
Actual
2016
Actual
2017
Projected
2018
Planned
Goal 7:
Maintain access to
vaccines for
international travel,
in part to prevent
travel associated
outbreaks in
Jefferson County.
Provide travel immunization
clinic (includes all disease
prevention recommendations,
including for malaria and
other diseases).
Number of clients immunized in travel
immunization clinic
Adults:
162
Adults:
140
Adults:
152
Adults:
174
Adults:
160
Adults:
160
0 – 18 yr:
23
0 – 18 yr:
31
0 – 18 yr:
55
0 – 18 yr:
36
0 – 18 yr:
40
0 – 18 yr:
40
Total:
185
Total:
171
Total:
207
Total:
210
Total:
200
Total:
200
Number of private supply vaccine doses
(routine and travel) administered by
JCPH (primarily for adults)
819 600 781 701 700 700
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.
Some children are not in the
IIS registry, and some
providers in Washington state
don’t participate in the
registry. The CDC NIS survey
is more complete.
Completeness of full immunization
series for children seeing Jefferson
County providers, at age 19-35 months:
4 DTaP, 3 Polio, 1 MMR, 3 HIB, 3 Hep-B,
1 Var, 4 PCV.
Jeff Co:
53% (IIS)
WA:
71% (NIS)
Jeff Co:
55% (IIS)
WA:
67% (NIS)
56% (IIS)
Jeff Co:
58% (IIS)
WA:
77% (NIS)
58% (IIS)
Jeff Co:
63% (IIS)
WA:
(NIS NA)
59% (IIS)
Jeff Co:
66%
Jeff Co:
69% (IIS)
Percent of children seeing Jefferson
County providers having 1 dose of
MMR by age 19-35 months (IIS data)
Jeff Co:
75%
Jeff Co:
78%
WA: 79%
Jeff Co:
80%
WA: 82%
Jeff Co:
83%
WA: 81%
Jeff Co:
86%
Jeff Co:
89%
Percent of children seeing Jefferson
County providers having 4 doses of
DTaP by age 19-35 months (IIS data)
Jeff Co:
69%
Jeff Co:
66%
WA: 68%
Jeff Co:
73%
WA: 69%
Jeff Co:
76%
Jeff Co:
79%
Goal 9:
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 in 2012
and 2013.
* Jeff Co:
11.2%
WA:
10.3%
Jeff Co:
21.9%
WA:
10.9%
Jeff Co:
30.5%
WA:
8.6%
Jeff Co:
11.1%
WA:
8.2%
Jeff Co:
9%
Jeff Co:
8%
Jefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[4]
Goals Objectives Performance Indicators 2013
Actual
2014
Actual
2015
Actual
2016
Actual
2017
Projected
2018
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 368 320 311 290 320 290
Percent of female FP clinic clients age
24 and under screened for Chlamydia 60.4% 63.4% 60.3% 74.2% 74% 74%
Number of chlamydia cases reported to
the State, female, male, total
Fe: 68
M: 13
T: 81
Fe: 59
M: 18
T: 77
Fe: 42
M: 15
T: 57
Fe: 41
M: 15
T: 56
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:
19
Quest:
75
Total: 94
DOH Lab:
5
Quest:
135
Total: 140
DOH Lab:
13
Quest:
112
Total: 125
DOH Lab:
4
Quest:
148
Total: 152
140
140
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
185 350 238 242 300 300
Number of syringes exchanged 24,596 42,809 35,328 47,790 82,000 82,000
Goal 13:
Prevent fatal opioid
overdoses in
Jefferson County.
Provide overdose prevention
education to SEP clients.
Provide naloxone, for opioid
users, families and friends.
Number of naloxone kits dispensed,
included training for proper use. New
program in 2016. NA NA NA 45 130 130
Jefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[5]
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 PASS PASS PASS PASS PASS PASS
SUMMARY OF KEY FUNDING/SERVICE ISSUES:
Communicable Disease/Immunizations
JCPH CD/Immunization programs address locally identified and defined public health problems. Communicable disease prevention is primarily a locally funded
program, county milage 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. 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.
State/Federal funding for the Immunization Program Vaccine Accountability Contract was reduced by $743 for 2017. JCPH received $4,006 for 2017 to complete
the eight provider clinic monitoring deliverables for this contract. The DOH Immunization Program will be piloting the Diamond Project in the first half of 2018,
in one region, using a regional/State service delivery model for these immunization program tasks. This model may be phased in statewide in the second half of
2018. As of 8/17/2017, JCPH hasn’t received any information from DOH on funding or contract deliverables for 2018.
Immunizations have been identified as a Community Health Improvement Plan (CHIP) priority. JCPH immunization staff will continue to monitor VFC vaccine
usage trends, and immunization rates, in Jefferson County. This data is being affected by increasing issues within some modules of the WAIIS registry. As a result,
reports of the annual number of doses administered by private clinics may be inaccurate. DOH plans to have additional server capacity and WAIIS upgrades by the
end of 2017, which should improve the data reports. The electronic medical records program, is being assessed for all the types of data reports available.
Jefferson County Public Health – Planned Performance Measures 2018
Community Health – Communicable Disease Program
[6]
JCPH immunization staff will continue to co-chair and participate in the CHIP Immunization Workgroup, focusing on improving immunization rates for children
and adults in Jefferson County. CHIP activities and detailed outcome indicators are outlined in the CHIP plan.
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 immunization
record provided to the school, decreased in Jefferson County in 2016. This is one of the CHIP indicators and JCPH will continue to support the schools in their
work on this issue.
STD
The Family Planning and STD clinic follows 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 electronic medical records program is also being assessed for FP/STD data reports.
HIV Prevention
HIV/AIDS case management was regionalized in January 2017 and Kitsap Public Health District became the regional provider of HIV case management services
for Kitsap, Clallam, and Jefferson counties. A Kitsap staff member, based at Clallam County Health Department, provides services for Clallam and Jefferson
counties. Previously, this staff member was employed by Clallam County Health Department and provided services for Clallam and Jefferson counties. CDC
funding currently focuses 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 HIV tests for uninsured high risk clients, but there is no funding for JCPH 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 testing is being done through Quest lab.
The 2016 annual number of client visits, and syringes exchanged, in the SEP program was higher than in any previous year. The 2017 totals are projected to be
higher yet, as 41,080 syringes were exchanged, through 154 client visits in the first 6 months. DOH has provided SEP supplies to supplement our program,
however, there is no State funding for staff time. Both the increase number of client visits, and naloxone distribution and training, for opioid overdose prevention,
have increased staff time required for this program. Continued funding for naloxone through the Center for Opioid Safety Education at the UW and DOH is
uncertain. If this supply of naloxone does not continue, 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
helpful 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.
8/18/2017