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Health District Staff
Figure 1Early Immunizations Save Lifes
Mercer County – Celina City Health District(MCCCHD)
2013 Annual Report
2014 Annual Report
Healthy Communities
table of contents
Health Department Staff
Health Commissioner Report
Vital Statistics Division
Fiscal Division
Emergency Response Division
Health Services Division
Environmental Division
Health District Staff
Amy Littin, BS, MSM (EXT 1273)
Health Commissioner
Michelle Kimmel, RS (EXT1274)
Director of Environmental Health
Deb Scheer, RN, BSN (EXT 1298)
Director of Emergency Preparedness/
EPI Surveillance
Dr. Philip Masser, M.D.
Medical Director
Kristi Timmerman (EXT 1277)
Vital Statistics Registrar/ Billing Manager
Amber Mustard, BS (EXT 1271)
Fiscal Specialist
Julia Shaffer, R.N. BSN, (EXT 1279)
Director of Health Services
Chris Miller, R.S. (EXT 1272)
Environmental Sanitarian II
Amy Schmidt, RN (EXT 1282)
Public Health Nurse II, BCMH Coordinator
Andi Noonan, RN, (EXT 1280)
Public Health Nurse I
Leah Vantilburg RN, BSN (EXT 1269)
Public Health Nurse I
Lisa Vondrell, RN, BSN (EXT 1278)
Public Health Nurse I
Lindsay Hess, CMA (EXT 1270)
Office Medical Assistant
MCCCHD Organizational Hierarchy
District Licensing Council – 5 members
Mercer County – District Advisory Council – 24 members
Fiscal Specialist (1) FTE
Vital Registrar/Medical Billing Manager (1) FTE
Nurses (3) FTE, Nurses (2) PTE, & Office Medical Assistant (1) FTE
Employee Staffing
10 – Full Time Employees
3 – Part Time Employees
Director of Nursing (1) FTE
Health Services Division
Director of Emergency Response/EPI (1) FTE
Administration Division
Sanitarian II (1) FTE
Director of Environmental Services (1) FTE
Environmental Division
Medical Director (1) PTE
Health Commissioner (1) FTE
DAC Appointed Board of Health – 5 members
Public Health Commissioner’s Annual Report
Amy Littin
As the new Mercer County Health Commissioner for the last five months, I have had quite a learning curve. Although I have been in healthcare for the last 23 years, there are many variances in public health such as funding, resources, boards and the Ohio Revised Code that have created stepping stones for me to grow in my role as the Public Health Commissioner. I am thrilled to be back in my hometown and look forward serving the community that I have loved all these years.
We have many obstacles to overcome as we transition into a new phase for Mercer County Celina City Health District but I have a wonderful staff, who is very knowledgeable and hard-working. One of those obstacles is positioning ourselves for accreditation.
Mercer County-Celina City Health District Moves Closer to Accreditation
In 2015 MCCCHD and its health system partners called Community Organizations Linking Together (COLT) will be completing our third Community Health Assessment (CHA). The raw data that was extracted from the 2012 CHA allowed COLT to identify community health concerns and then prioritize these concerns. The top three areas of concern were; Obesity, Underage & Adult Binge Drinking and Opiate Drug Addiction. In 2013, with the CHA completed, COLT moved on to developing a Community Health Improvement Plan (CHIP).
The CHIP developed a vision and mission statements to provide purpose, meaningful goals, identified action step strategies for improving outcomes, as well as denoting specific agency that were best suited to address these actions steps. Throughout 2013, COLT – CHIP subcommittee held four quarterly meetings, whereby, a three year CHIP Implementation Plan was developed to chart future initiatives and report progress in the overarching goals of improving community access to healthcare and improving health outcomes. The CHIP has progressed over the last 2 years, however we have fallen short on some of the goals.
The third and final step to prerequisite accreditation eligibility will involve the Health District completing a five-year Strategic Plan in the summer of 2014, has not been completed yet due to changes in leadership. There are two other very important components of the process, which involve creating a Performance Management System and a Workforce Improvement Program. As we move further along in the process, we may be asking for more guidance from our boards and councils. The roles of the Board of Health and District Advisory Council will be more integrated as well as proactive relative to the Health Department. We look forward to working together to provide stronger and healthier outcomes for Mercer County.
VITAL STATISTICS DIVISION
Kristi Timmerman
"Statistics are like a bikini. What they reveal is interesting. But what they hide is vital."
-- Aaron Levenstein
2014 Vital Statistics – Birth and Death Record Reports
Vital Statistics:
· Statewide Issuance: Mercer County has the ability to issue birth certificates for anyone born in the State of Ohio after 1908. Prior to January 2011 the department was only able to issue certificates for those born in Mercer County.
· Ohio Administrative Code 3701-40-08: Boards of Health responsibility include: Distributing the ODH brochure, A Sound Beginning…Parent information about Universal Newborn Hearing Screening, to each family who registers a Home Birth; collecting a signature from that family for receipt of the brochure, and reporting to the Ohio Department of Health the number of brochures distributed.
Records of births and deaths occurring within Mercer County are submitted by funeral directors, hospitals, or individuals involved. The Local Registrar of Vital Statistics then reviews the documents for completeness and accuracy before filing the record.
The birth and death records on file at our office include December 1908 to the present time. These records are filed by date of the event. Since an alphabetical index is required and is public information, we have the birth index for 1908 to the present time. For deaths, the period completed is from 1909 through the current time. We also have all the births and deaths on database which is searchable by name, by date, or by parent’s names.
Certified Birth Certificates issued in 2014…………………………….1,529
issued in 2013…………………………….1,453
issued in 2012…………………………….1,454
Issued in 2011…………………………….1,458
Issued in 2010…………………………….1,415
Issued in 2009…………………………….1,832
Issued in 2008…………………………….1,849
Certified Death Certificatesissued in 2014……………………………..1,134
issued in 2013……………………………..1,247
issued in 2012……………………………..1,280
Issued in 2011……………………………..1,121
Issued in 2010……………………………..1,336
Issued in 2009……………………………..1,363
Issued in 2008……………………………..1,262
Burial Permits must also be issued by the Local Registrar before final disposition by cremation, interment, or deposit within a tomb or vault. There are Sub-Registrars located in Ft Recovery, Coldwater and Rockford to assist with issuance of Burial Permits after hours, weekends, and for the convenience of out-of-the-area funeral homes. In 2014 we issued 48 Burial Permits at $3.00 each. The State’s portion of this fee, which is $2.50, is used by the Ohio Cemetery Dispute Resolution Committee.
Report of Births for 2014
The following births occurred within Mercer County and were filed in 2013. These statistics do not include Mercer county residents who gave birth in other counties.
Total number of births filed in 2014…………………………………..351
2013…………………………………..364
2012……………….………………….342
2011……………….………………….362
2010…………………………………..340
2009…………………………………..356
2008…………………………………..344
Birth Registration by Sex
201420132012201120102009 2008
Males179192182203176178154
Females172171160159175177181
201420132012201120102009 2008
Home Births 2 2 1 1 0 1 1
Birth Registration by Mother’s Residence
2014201320122011201020092008
Mercer Co 284314285 298296293 281
Auglaize Co 13 11 22 16 17 17 16
Darke Co 29 21 21 32 23 24 24
Shelby Co 05 03 03 04 00 04 03
Van Wert Co 07 06 02 02 01 09 06
Jay Co, IN 09 03 03 07 01 07 02
Others 04 05 06 03 02 02 03
Mortality Report for 2014
Statistical information related to the primary cause of death filed in 2014 and occurring in Mercer County, Ohio.
Heart Disease126
Malignant Neoplasms 55
Alzheimer’s/Dementia 22
Other Causes 15
Respiratory Failure 21
CVA Disease 9
COPD 8
Accidents 8
Pneumonia & Aspiration 14
Renal 6
Suicide 3
Arteriosclerosis 6
Fetal 0
Diabetes Mellitus 1
Homicide 0
SIDS 1
Chronic Liver Disease & Cirrhosis 3
__________________________________________________________________
Total Deaths Filed in 2014 298
Malignant Neoplasm's as the Primary Cause of Death
Renal- 1, Colon-7, Brain-3, Liver-1, Lung-12, Bladder-2, Pancreatic-5, Esophageal-4, Breast-11, Ovarian-1, Kidney-1, Stomach-1, Prostate-4, Melanoma-2, Endometrial-3, Rectall-1
Malignant Neoplasms as a contributing factor to the cause of Death
Breast-2, Lung-4, Liver-3, Prostate-1, Malignant Melantoma-2, Brain-1, Colon-1, Bladder-2, Pancreas-2, Uterine-1, Larynx-1, Metastatic (unknown)-1
Primary Causes of Death for those having Malignant Neoplasm's as Contributing Factors:
ASHD-1, Cardiopulmonary Failure-5, Respiratory Failure-2, MI-4, Renal Failure-1, malignant neoplasms-1, Pneumonia-1
A total of 20 Mercer County Death Certificates reflected cancer as a contributing factor to the primary Cause of Death in 2014, compared to 24 in 2013, 17 in 2012 and 14 in 2011.
Causes of Death Ruled as Accidental:
Vehicular: 5
Smoke inhalation-0
Multiple drug intoxication-3
Deaths Ruled as a Suicide:
3 filed with average age of 38 yrs. (3 males)
Title VI Compliance Statement
This agency will operate in accordance with TITLE VI: No person in this agency shall, on the grounds of race, color, national origin, handicap, (age, sec and/or religion, where applicable), be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives Federal financial assistance.
FISCAL DIVISION
Amber Mustard
Accurate Calculations for Undefined Growth
The 2015 General Fund Budget
· The General Fund Estimated Revenue: $1,334,491.52 of which $295,500 is the DAC revenue. The DAC payment makes up 22% of the Health District’s General Fund Revenue.
· The General Fund Estimated Expenses: $1,393,798.38. The $295,500 DAC payment helps fund 21% of the Health District’s General Fund Expenses.
· 2016 General Fund Budget: As per ORC, Health Districts are required to submit a tentative general fund budget to the County Auditor by the First Monday in April of each year. The Health Districts have not requested any additional DAC monies over the past three years. NOTE: The Health District will not request any additional monies from the DAC in 2016.
· The Total Audit Payment for (2009-2014) Federal Grants were $218,935.92. There was a 2014 Carryover Balance of $288,886.92.
· We recently completed & submitted the 2014 Annual State Auditor & Ohio Department of Health Annual Financial Reports.
PUBLIC HEALTH PREPAREDNESS/
EPIDEMIOLOGY
Deb Scheer
Community MRC Volunteers Making a Difference
Emergency Response
The division of Emergency Response had a very busy year. We continue to promote “Saving Minutes”, which is a grant funded program bringing a functional need registry to Mercer County. This database will allow citizens to voluntarily enter information that will allow first responders to quickly identify and respond to their needs in an emergency.
We also continue to recruit members for the Medical Reserve Corps (MRC). The MRC is a great way to volunteer your time and expertise during a disaster. For more information please log on to www.ohioresponds.gov . We encourage individuals to register before emergencies arise.
Participation in county coalitions, trainings and exercises are crucial to improve community response and resiliency. Mercer Health Hospital and MCCCHD held a combined functional exercise with county partners in the Spring to test capabilities of responding to a mass fatality incident. Another full scale exercise was completed through the Mercer County Healthcare Disaster Preparedness Coalition (MCHDPC) in December involving Ebola. Plans were developed and exercised during these incidents, with “hot washes” completed after to discuss strengths and weaknesses.
Epidemiology and Surveillance
Public health epidemiologist (Epi) agencies are critical for detecting, controlling, and preventing major health outbreaks. Local Epis elucidate and communicate risks and recommend actions to prevent and/or control an array of serious threats to our community’s health. The MCCCHD Epi collaborates with several partners in the Mercer, Auglaize, Van Wert and Allen Counties (a.k.a. Fab-4), as well as the North West Region, Ohio Department of Health, and Center for Disease Control.
Disease surveillance tools are used to monitor, predict, observe, and minimize the harm caused by outbreak, epidemic, and pandemic situations. It also increases knowledge about which factors contribute to such circumstances. Ebola is an example of the increase in the global impact of infectious disease, which has made it necessary to create surveillance and monitoring that extend beyond the traditional public health focus. It is imperative to record the spread of diseases to develop patterns of progression and therefore a course of action.
ANNUAL DRIVE-THRU FLU CLINIC
2014 Mercer County Communicable Disease Cases
ODH - Ohio Disease Reporting System
Date: 1/2/15
Disease Type
#
Campylobacteriosis
24
Chlamydia infection
78
Cryptosporidiosis
14
E. coli - enterohemorrhagic (shiga toxin producing) - Not O157:H7 2
1
E. coli - enterohemorrhagic (shiga toxin producing) O157:H7 5
2
E. Coli - Unknown
2
Giardia
3
Gonnorhea
8
Hepatitis A
0
Hepatitis B - acute
2
Hepatitis B - chronic
3
Hepatitis C - acute
0
Hepatitis C - chronic
56
Influenza-associated hospitalization
22
Legionnaires' Disease
0
Lyme Disease
0
Meningitis - aseptic/viral
3
Mycobacterial disease - other than tuberculosis
4
Pertussis
3
Rubella - not congenital (call health department immediately)
1
Salmonellosis
8
Shigellosis
2
Streptococcus pneumoniae - invasive antibiotic resistance unknown or non-resistant
5
Streptococcus pneumoniae - invasive antibiotic resistant/intermediate
0
Tuberculosis
1
Varicella
9
West Nile virus disease (also current infection)
0
Yersiniosis
6
Total Communicable Diseases
289
HEALTH SERVICES DIVISION
Prevent Promote Protect
Health Services Summary for 2014
The Mercer County Celina City Health Department (MCCCHD) Health Service Staff includes the following Medical Personnel:
Julia Shaffer, BSN RN Director of Nursing (FTE) 80 hours 10 years of service
Amy Schmidt, RN BCMH Coordinator (FTE) 64 hours 7 years of service
Lisa Vondrell, BSN RN Public Health Nurse (FTE) 64 hours 1.8 years of service
Lindsay Hess, CMA Office Medical Assistant 80 hours 1.9 years of service
Leah Vantilburg, BSN RN Public Health Nurse/MRC 48 hours 1 year of service
Andrea Noonan, RN Public Health Nurse 16 hours 3 years of service
Immunization Program:
Our six staff administered 15,032 vaccines in 2014. Protecting our community against 17 life threatening diseases, Diphtheria, Tetanus, Pertussis, Hepatitis B, Hepatitis A, Haemophilus, Pneumococcal, Measles, Mumps, Rubella, Chickenpox, Shingles, Influenza, Rotavirus, Polio, Meningococcal, and human papillomavirus!
*** Please see Appendix A for details.
Our success is measured by disease we do not see.
The Immunization Program serves any person regardless of location of residency. The immunization administration guidelines are dependent on the Advisory Committee on Immunization Practices (ACIP) and follow physician orders through the MCCCHD Medical Director, Dr Philip Masser. The immunization vaccine supply is dependent on federal and state funding regulations.
65% of the vaccine administered is funded by the MCCCHD, purchased directly from the pharmaceutical companies. Childhood vaccines were mandated to be purchased by the federal government through the Affordable Care Act. Health Insurance purchased before March 23, 2010 could be grandfathered to exclude the vaccine cost. All other Health Insurance policies were to include vaccines approved by the ACIP. The MCCCHD maintains agreements with Children’s Purchasing Pediatrics for Sanofi Pasteur and Merck vaccines, the AOHC for influenza vaccine, and the Department of Administrative Services Office of Procurement to purchase Prevar 13. The MCCCHD cost of vaccine is monitored with each order and adjusted in accordance with manufactures vaccine cost.
33% of the vaccine administered is federally funded through the Vaccine for Children Program.
Vaccine for Children (VFC) includes children through 18 years of age who meet the guidelines for VFC. These guidelines include children who are medicaid eligible, uninsured, underinsured, or Native American/Alaskian natives.
2% of the vaccine administered is state funded through the general revenue fund. The general revenue fund (GRF) vaccine is used for children 18 years and under who are not eligible for VFC vaccine and have insurance that applies the cost of the vaccine toward the deductible leaving the parent with high payment for the immunizations. The GRF vaccine has been announced to end June 30, 2015.
The Billables Vaccine Project ended July 31, 2014. Since August 1, 2014, children, 0 thru 18 years, with private health insurance are given vaccine purchased by the MCCCHD. The GRF continues to be used for children whose insurance applies the vaccine cost towards a deductible.
The total received from the insurance reimbursement totaled $555,925.85.
The total payment to the Ohio Department of Health totaled $440,181.31.
The difference added to the Purchased Vaccine Account was $115,744.54.
*** For detailed information please see Appendix B
Projected Vaccine Cost for 2015 is $589,884.78
*** For detailed information please see Appendix C
The MCCCHD participated in the Strategies for Increasing Teen Immunization Rates (STIR) Grant. This was a one year grant initiated by the CDC to increase teenage vaccine immunization rates. Tdap, Meningococcal and HPV vaccines were targeted. Three Teen Immunization Education Sessions were given to vaccine providers in the county. Three offices were assessed for immunization rates. Allen County Health Department was the lead agency for Mercer County. Mercer County receives a maximium of $1950 from the grant.
In 2015, the MCCCHD is part of the Immunization Action Plan Grant (IAP). This is the first year MCCCHD has participated. Auglaize county is the lead agency for this grant. The IAPgoal is to increase immunization rates for childhood vaccines so that all children are immunized by two years of age. Mercer county will receive a maximium of $22,100.
Bureau of Children with Medical Handicaps (BCMH)
BCMH is a program provided by the Ohio Department of Health that helps ensure quality healthcare for children with certain eligible health conditions. In some cases, it is secondary to the family’s primary insurance and in others, it is the only coverage these children have. Each county has a designated Public Health Nurse to monitor and facilitate coverage of eligible children that reside in that particular county. This is done through phone, email, home visit or whatever preferred method of contact is convenient for the family.
Home Visits: 37
Service Coordination Cases: 7
Average number of treatment cases: 128
Average number of diagnostic cases: 20
Help Me Grow Cases: 4
Total amount billed 2014$32,770.00
Total amount paid 2014$23,880.00
Total amount unpaid 2013$8,930.00
Amount adjusted off 2013$710.00
One example of a covered condition is Cystic Fibrosis (CF). This disease is genetic and causes issues with a variety of bodily functions. CF causes thick mucus that makes breathing difficult and lung infections frequest. The thick mucus also affects other organs, including the pancreas and liver. These children have difficulty absorbing nutrients and require enzymes every time they eat. There are many medications needed to counteract the effects of the disease and insurance does not always cover completely. CF children requeire frequent visits to the doctor and often long hospital stays for lung treatments (clean outs).
The following is a letter written by the mother of a Cystic Fibrosis child.
“At just 18 days old, our precious son was diagnosed with Cystic Fibrosis. In the first couple of months we were completely overwhelmed with having to learn about all the medications and treatments our son would have to go through for the rest of his life, but the most stressful part was the financial aspect. Thanks to BCMH, our son is able to have the quality healthcare he needs in order to live a long and healthy life. We are grateful for the benefits provided to us by BCMH, because they help reduce our financial burden.”
School Nursing
The MCCCHD has school nursing contracts with Fort Recovery and St Henry School Systems.
Vision and Hearing Screenings are completed by an ODH trained RN.
In 2014, 1199 children were screened in the schools. Of these, 144 were referred for a complete assessment by a specialist.
Child Fatality Review (CFR)
Child Fatatlity Review Board is a state requirement with the goal of initiating education or other changes in the community to prevent childhood deaths. The Board is requeired to meet yearly to review the deaths of all the children under the age of 18 years. The Board will review the deaths of three Mercer County children who died in 2014. The main initiative is to raise awareness of deaths from unsafe sleep practices by educating everone with an infant.
Ohio Buckles Buckeyes (OBB)
The Ohio Buckles Buckeyes program supplies new car seats to any infant/child that does not have an appropriate Child Passenger restraint and is eligible for Women, Infant, and Child Services. MCCCHD has two Child Passenger Safety Technicians that educated parents and taught installation for 51 seats. The MCCCHD recognizes that motor vehicle accidents is the second leading cause of death in children 4-10 years old. Mercer County had 6 fatal crashes in 2014 and no childhood deaths from motor vehicle accidents.
Community Education
Education is the best way to keep a community healthy.
The MCCCHD participates in Community Events such as the Community Organizations Linked Together, the Grand Lake Health Challenge, the Mercer Health Healthy Expo, and the Mercer County Fair. A Communicable Disease Class for Child Care Providers is taught annually and includes both the initial course and refresher course. Speaking engagements include Wright State Lake Campus, The Celina Manor, and St Henry Preschool. The MCCCHD updates and works in coorporation with the physician offices, the pharmacies, the long term heatlthcare facilities, the hospitals, and the schools in the Mercer County Area.
Julia Shaffer, RN BSN
Director of Nursing
419-586-3251 ext. 1279
ENVIRONMENTAL DIVISION
Michelle Kimmel
Chris Miller
Preserving Our Community
Environmental Division – 2014 Summary of Prominent Activities
Besides keeping up with the routine inspections that are required by state regulations, such as
food service inspections, water well and septic system permitting and inspections, nuisance
investigations, solid waste inspections, and rabies prevention, the Environmental Division deals with enforcement cases and changing regulations which require education of both the department and the constituents that are impacted. This document will highlight those activities that consumed a considerable amount of our focus this past year.
As evidenced in our statistical analysis of time / hours spent in various program areas, the construction and demolition debris program showed significant increase in 2014. This is due to the on-going enforcement case against Dumpsterman Container Service I New Source
Management, LLC located at 6980 Staeger Road, Celina. The operation is a self-proclaimed recycling center, of which their original intent was to take in construction and demolition debris material, which would be sorted and recycled. Such a facility is not required by state law to be licensed and inspected since the waste brought in is not to be "disposed" there - only sorted and marketed and moved out in a continual flow of materials. The continual flow of materials
is not happening - rather, the materials are brought in and added to piles, which have at the least, remained static, if not continually increasing, in size. Due to numerous complaints received by the department, and verified violations of the health department's property maintenance code, the corporation was under orders from the Board of Health to remove accumulated materials which meet the definition of "rubbish" under the Mercer County -Celina City Health Department Property Maintenance Code by June 2, 2014. After the deadline, in which compliance was not achieved, the case was turned over to the Mercer County Prosecuting Attorney. Court proceedings followed, in which the corporation was given an additional 90 days to come into compliance, or face a misdemeanor fine and possible contempt of court findings. The court's deadline (November 24, 2014) passed, also, with non-compliance. A second court proceeding produced the assessment of the misdemeanor fine and a scheduled, compliance plan - accountable to the court for the next few months with a final deadline of April 15, 2015. Throughout this scheduled compliance plan, the Environmental Division will need to report to the court concerning the progress or lack thereof toward clean up. Hopefully this situation is resolved by the time we report at the beginning of next year! If DumpstermanI New Source fails to comply and "walks away" from the issue, our focus will turn to the current property owner, Strawn Investments, before any taxpayer dollars are used to clean up the property.
The other main topic toward the end of 2014 was preparation for the implementation of the new state sewage treatment regulations, which came into effect January 1, 2015. We have been aware of this eventuality since 2007, when the former state sewage regulations were rescinded by the state legislature. Many of the major aspects of the rule have not made a huge impact on how systems are basically installed. We were already in compliance with the "no off lot discharge", EPA requirement. Since 2007 we have incorporated the soil evaluation survey proposal. Therefore, the changes to systems installations going forward with the new rules will be minimal. However, the biggest impact that we will see is the component of the new rule that requires all counties to develop an operation and maintenance program for all the existing septic systems in their jurisdiction. Thankfully, they have allowed flexibility on the timeframes for having all systems under this program. We will be working on our plan during this upcoming year, and would like feedback from groups such as the District Advisory Council as to the most reasonable approach toward meeting this requirement.
As always, we thank townships, villages and city for your support to our department. Through
your contributions, we are able to provide the services described in this report. If you ever have specific concerns, please feel free to contact us!
Michelle Kimmel, R.S.
Director of Environmental Health
Environmental Staff:
Michelle Kimmel, R.S. 419-586-3251, ext. 1274
Christopher Miller, R.S. 419-586-3251, ext. 1272
2014 Environmental Activities by Political Subdivision
Township / Village
# Calls / Trips
Blackcreek
22
Burkettsville
6
Butler
40
Celina
321
Center
35
Chickasaw
11
Coldwater
97
Dublin
25
Fort Recovery
52
Franklin
102
Gibson
21
Granville
60
Hopewell
18
Jefferson
166
Liberty
30
Marion
85
Mendon
15
Montezuma
4
Recovery
39
Rockford
35
St. Henry
49
Union
58
Washington
28
Office entries - collective
1865
Total Activities
3185
Environmental Program Inspections 2014
Food Services
707
Septic Permits / Inspections
177
Nuisances (all types) - 200 total hours
84
Private Water Systems - permits issued
61
Water Samples
125
Solid Waste Facilities (all types)
14
Schools
32
Manufactured Home Parks
23
Campgrounds
15
Pools
44
Tattoo / Body Piercing Establishment
2
Total Hours128
Environmental Program Hour Allotment
Environmental Concern
Hours spent
Household Sewage Treatment
719
Emergency Response Training
123
Private Water Systems
379
Water Sampling
83
Rabies Control
114
Real Estate Inspections
68
Landfill
19
Transfer Station
12
Infectious Waste
3
Solid Waste District
24
Construction & Demolition
132
Compost facilities
12
General solid waste
80
School Buildings
12
Mobile Home Parks
50
Campgrounds
59
Swimming Pools
48
Temporary Food Operations
59
Mobile Food Operations
42
Food Operations
734
Vending machines
8
Tattoo issues
25
Infectious Disease / Zoonotic
47
Environmental comprehensive
411
General office assistance
136
Total Hours 3371
Billables Vaccine ProjectAPPENDIX B
The Billables Vaccine Project was initiated March 7, 2013 and completed July 31, 2014. The following table is a composite of the immunization efforts through billing private insurances for the cost of the vaccine and does not include administration fees. This was a pilot program managed by the Ohio Department of Health. The main purpose of the pilot program was to help Ohio Public Health Departments develop private billing practices and funds enabling the Health Department to be self-sustaining in billing private insurance for private purchased vaccines for all children, 0 thru 18 years, covered by private insurance.
2013 Month
Insurance
Reimbursement
ODH Payment
difference
January
February
March
$19,538.43
$15,980.54
$3,557.89
April
$28,559.55
$23,157.10
$5,402.45
May
$28,980.51
$23,725.45
$5,255.06
June
$36,781.44
$29,209.89
$7,571.55
July
$46,048.91
$36,547.99
$9,500.92
August
$60,255.24
$47,356.72
$12,898.52
September
$26,362.60
$20,905.49
$5,457.11
October
$28,338.90
$22,713.40
$5,625.50
November
$28,260.51
$22,559.29
$5,701.22
December
$27,251.47
$21,562.95
$5,688.52
2014 Month
January
$35,263.86
$28,125.36
$7,138.50
February
$25,331.41
$20,117.26
$5,214.15
March
$34,202.51
$26,596.34
$7,606.17
April
$34,884.83
$27,470.34
$7,414.49
May
$29,653.85
$23,180.34
$6,473.51
June
$35,286.60
$27,008.61
$8,277.99
July
$30,925.23
$23,964.24
$6,960.99
Total difference added to the Purchased Vaccine Account:
$115,744.54
2015 Projected Vaccine CostAPPENDIX C
Purchased Vaccine
Doses Administered
Project Cost
DI Kinrix
251
$11,935.05
DHI Pentacel*
666
$38,941.02
Dtap Daptacel
235
$4,415.65
HAV-HBV Twinrix
169
$9,911.85
Hepatitis A Adult 1cc
143
$7,561.84
Hepatitis A Ped 0.5cc
940
$22,043.00
Hepatitis B ped 0.5cc
29
$332.92
Hepatitis B Adult 1cc
69
$2,841.42
HIB
832
$14,842.88
HPV gardasil*
634
$87,637.82
Menactra
464
$46,061.28
MMR
581
$33,134.43
PNE pneumovax 23
32
$2,143.68
prevnar 13
862
$120,680.00
Rota rotateq
495
$34,278.75
Td
5
$116.60
Tdap Adacel
752
$24,206.88
Var varivax
809
$77,413.21
Zostavax
78
$13,357.50
Trumenba*
20
$2,315.00
IIV4 0.5cc (Influenza)
800
$14,320.00
IIV4 0.25cc (Influenza)
200
$3,500.00
High dose (Influenza)
350
$10,346.00
LAIV (Influenza)
400
$7,548.00
Total Vaccine Cost
$589,884.78
The Price of Prevnar 13 is an average cost for the year. In June the price is expected to increase.
At this time, ODH will not be providing non-vfc influenza vaccine for the 2015-2016 season.
Trumenba is a new product coming onto the market in 2015. ACIP guidelines are not completed.
Gardasil will be replaced with HPV 9 at an unknown price.