ANNUAL REPORT FISCAL YEAR 2015

Lori Brewster, M.S., APRN/BC, LCADC Wicomico Health Officer

Publication date: September 1, 2015

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

The health department is making strides to address many of the public health needs in our community.

Our Community Health Assessment (CHA) Survey, which is done every five years, assisted the Local Health Improvement Coalition to determine our direction for 2015 to 2020. Areas identified as our target over the next 5 years include: Access to Care, Behavioral Health, Chronic Disease (Diabetes, Obesity,

Nutrition and Physical Activity), Oral Health Care for Adults, and Tobacco. Subcommittees of the Coalition continue to work diligently to address the identified community needs. Members of the community that would like to complete the next CHA, may do so at www.wicomicohealth.org.

Health Department programs and services continue to impact many of the areas identified in the Community Health Assessment Survey as well as other areas of need. Committed Health Department employees are working very hard every day to move the needle on the public health issues effecting our community.

This document presents data and initiatives to address many of these issues.

Lori Brewster Wicomico Health Officer

I would like to recognize and thank the employees of the Wicomico County Health Department for the work they provide to the public on a daily basis.

The services and information they provide to County residents are incredibly important for community health and aware-ness.

The public is encouraged to research services that the Health Department may provide that they may be unaware of – such as their Women, Infants, and Children's program, Environmental Health services, and assistance to citizens who may not otherwise have health care provided to them.

The Wicomico County Health Department deserves to be commended for their diligent work for the well-being of our beautiful County.

Bob Culver Wicomico County Executive

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

ACCESS TO CARE

According to the 2014 Community Health Needs Assessment, opportunities for improvement exist with regard to individuals having a specific source for ongoing health care in the community.

Improving health care services depends in part on ensuring people have a usual and ongoing source of care. Better health outcomes and fewer dispari-ties and costs are achieved when people have a routine source of care.

While 79.7% of people in Wicomico County have a particular place identified for medical care, only 69.9% of people identified have a specific source of ongoing medical care. Healthy People 2020 target is 95% or higher.

A sub-committee of the LHIC is organizing to explore the causes for this issue and to develop a plan to address opportunities for improvement.

Language interpretation services are provided to Limited English Proficient (LEP) clients at no cost to them, through bi-lingual staff, medically certified contract interpreters and telephonic language services.

Number of LEP clients served: 2,781 Cost to provide LEP service: $23,778.98

ORAL HEALTH CARE FOR ADULTS

The 2014 CHNA survey showed that only 60.4% of adults in Wicomico had seen a dental provider in the last year, compared to 72.7% statewide.

In FY 2015, an Adult Dental Safety Net Task Force was established and tasked with developing strategies to improve this health care challenge.

Plans for FY16 include developing an administrative structure to apply for and manage grant funds and screen indigent clients with dental needs, and to develop a network of providers willing to provide dental services at reduced fees. The Task Force will also collaborate with other stakeholders and groups working around the state on adult dental care access.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

BEHAVIORAL HEALTH

The Methadone Maintenance Program was re-accredited by the Joint Commission in March 2015 and continues to expand in response to the opioid use epidemic.

Joint Commission accreditation challenges providers to think creatively and to focus on performance improvement.

Accreditation also strengthens community confidence, quality and safety of care, treatment and services.

In FY 2015, Wicomico Behavioral Health and Community Health Services programs developed a partnership to provide bi-directional mental health, substance abuse and family planning referrals and services to women of child bearing age. This program, known as the Family Planning: Wicomico Mental Health and Substance Abuse Treatment Collaboration, has in-creased access to care for uninsured as well as LEP clients.

The Family Planning: Wicomico Mental Health and Substance Abuse Treatment Collaboration has been successful in preventing unnecessary emergency petitions and emergency room visits.

Crisis Intervention Team (CIT) training is designed to train first responders to support people in a behavioral health crisis.

In FY 2015, 54 police and correctional officers from Wicomico and Somer-set counties completed the 40 hour CIT training course.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

ADDRESSING PRESCRIPTION DRUG ABUSE

In calendar year 2014, 20 individuals died of a drug overdose in Wicomico County. Wicomico’s Overdose Fatality Review Team reviews each overdose case and provides information to create prevention strategies to further pre-vent deaths due to overdose.

In FY 2015, 162 individuals were certified to administer Naloxone®, includ-ing 50 members of the community and 112 law enforcement officers from Fruitland City Police. Salisbury City Police, Wicomico County Sheriff's Office, and Delmar City Police.

Drug Free Wicomico and the Prescription Drug Task Force includes over 40 members, who have been involved in developing a comprehensive Opiate Media Campaign with a.s.a.p.r. Integrated Marketing that will run through September 2015.

The Wicomico County Drug Action Response Team (DART) is a group of drug free youth from local high schools who have been meeting for over two years. Their mission is to provide information to children, youth and adults on legal and illegal drugs.

In FY 2015, DART members developed a script and a song for social media to educate peers on drug use.

In FY 2015, 599 pounds of prescription and over the counter medications were collected at drop boxes at the Wicomico County Sheriff ’s Department, City of Salisbury, Delmar, and Fruitland Police Departments.

In FY 2016, new drop boxes will be added at the Maryland State Police Salisbury Barracks and Apple Discount Drugs in Fruitland to increase access.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

CHRONIC DISEASE

With the release of the 2014 Community Health Needs Assessment, the LHIC elected to merge diabetes and obesity under the Chronic Disease umbrella since the strategies to improve both conditions are much the same. This group now serves as the Live Healthy Wicomico Task Force.

According to the 2014 CHNA, the prevalence of obesity in Wicomico County is 37.3% and diabetes prevalence is 16.5%. Strategies for improvement will be focused on the following: Promoting a shared culture of healthy living through community

engagement by increasing access to healthy foods and enhancing the built environment to support active living.

Establishing formal referral systems linking at risk patients to follow-up health care.

Improving identification of undiagnosed persons with pre-diabetes in clinical settings.

Activities that improve diabetes and obesity in the community will also have an impact on other chronic diseases such as hypertension, heart disease, stroke, cancer and behavioral health problems.

DIABETES

2014 County Health Rankings data shows

the rate of diabetic screening is 84%

in Wicomico County.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

TOBACCO

Although the trend for cigarette smoking is going down as reported by Network of Care, Healthy People 2020 goals have yet to be reached:

The Cigarette Restitution Fund (CRF) Tobacco Program awarded two community agencies $4,500 each to provide tobacco education to the com-munity. Awardees Jireh Community Development, Inc. and St. Paul Commu-nity Empowerment Center, Inc. focused on educating youth and adults on the dangers of e-cigarettes. Health fairs, educational classes and a community fun day event were conducted.

The CRF Tobacco program partnered with the Maryland Behavioral Health Administration to host the 15th Annual Underage Substance Use Reduction Luncheon, recognizing enforcement officers, local establishments and community members for their hard work and dedication to reducing substance use in Wicomico County.

Due to the high rate of pregnant women that smoke in Wicomico County, three community agencies were granted $3,800 each through the Center for Tobacco Prevention and Control PATCH (Pregnancy and Tobacco Cessation Help) initiative. Destiny Family, Inc., Empowered Women Ministries, Inc., and Wicomico Family Support Center used the funds to educate pregnant women, women of child-bearing age and their households on the dangers of tobacco use and second-hand smoke. Educational classes, health and wellness workshops, staff trainings and community health fairs were used to bring awareness and education to the community.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

SEXUALLY TRANSMITTED INFECTIONS

The Wicomico STI Task Force has received statewide recognition for its suc-cess, and as an innovative community collaboration.

Since the Task Force began in 2013, Wicomico County has seen a 19.4% re-duction in Chlamydia rates, and an 11.5% reduction in Gonorrhea rates, while rates statewide continued to increase.

In 2014, Wicomico had a Chlamydia

incidence rate of 566.3 per

100,000 population compared to a

2013 incidence rate of 640.2 per

100,000 population.

In 2014, Wicomico

had a Gonorrhea incidence rate

of 185.2 per 100,000 population compared to a 2013

rate of 193.3 per 100,000 population.

Network of Care, 2015 DHMH Center for

STI Infection, 2013

Chlamydia in Wicomico County, 2005 - 2014 (Cases/100,000 population)

Wicomico

Maryland

US

MD Counties

Gonorrhea in Wicomico County, 2005-2014 (Cases/100,000 population)

Wicomico

Maryland

US

MD Counties

Maryland Dept. of Health and Mental Hygiene, 2014 * Note: US 2013 rates (US 2014 rates not yet available.)

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

PROGRAM ACCOMPLISHMENTS

Environmental Health staff coordinated 4 rabies clinics throughout Wicomico County, allowing 484 dogs and cats to be vaccinated against rabies.

61 septic systems were upgraded, preventing over 700 pounds of nitrogen from entering our ground and surface waters.

In April 2015, the Resource Coordination program transitioned to the Coordination of Community Services Program. Program staff continues to coordinate information and referral services to developmentally disabled adults, children, and their families.

In FY 2015, program staff reached out to the community through several resource fairs and were instrumental in promoting the Mission of Mercy, an all volunteer mission providing free adult dental services.

The Psychiatric Rehabilitation Program (PRP) has seen an increase in the number of children and adults referred and enrolled into the program.

With this increase in caseload, two new staff members have been hired, increasing program staff size from three to five full time employees.

In FY15, health department staff attended 31 health fairs to promote public health initiatives and increase awareness of programs and services.

@WicomicoHealth continues to maintain active social media accounts, with 1,785 Facebook® and 596 Twitter® followers. Instagram®, Pinterest®, and YouTube® pages continue to increase in number of followers.

PRP New Clients Admitted

FY FY 2014 2015

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

WICOMICO HEALTH IN THE COMMUNITY

Wicomico Health staff work tirelessly to meet the public health needs of the community through regular clinics, vaccination clinics, car seat checks, health fairs, and other events.

In observation of National Public Health Week, an individual is awarded the Outstanding Public Health Leader Award for Wicomico County. In April 2015, Celeste Savage (top left in the photo below) was recognized for her efforts to help the most vulnerable in our community.

108 East Main Street Salisbury MD 21801 (410) 749-1244 www.wicomicohealth.org

LOCAL HEALTH IMPROVEMENT COALITION

Adventist Health Care

City of Salisbury

Coastal Hospice

Community Empowerment Center

Community Foundation of the Eastern Shore

Community Members

Deer’s Head Center

Eastern Shore Area Health Education Center

Health South Chesapeake Rehab

Holly Center

Hope, Inc.

K & L Microwave

MAC, Incorporated

Peninsula Regional Medical Center

Shore Transit

St. James AME Zion Church

Three Lower Counties (TLC)

United Health Care

University of Maryland Agriculture and Natural Resources

Wesley Temple

Wicomico County Board of Education

Wicomico County Department of Social Services

Wicomico County Detention Center

Wicomico County Government

Wicomico County Health Department

Wicomico County Recreation and Parks

Wicomico County Sheriff’s Department

Worcester County Health Department

Wicomico’s Local Health Improvement Coalition reviewed the newly released 2014 Community Health Needs Assessment (CHNA).

A CHNA provides information so that com-munities may identify issues of greatest concern and decide to commit resources to those areas in order to make the greatest possible impact on community health status. A CHNA serves as a tool to assist communities to reach 3 basic goals: To improve residents’ health status,

increase their life spans, and elevate their overall quality of life.

To reduce the health inequalities among residents. To increase accessibility to preventive service for all community residents.

The entire CHNA document may be viewed at www.wicomicohealth.org.

Priority focus areas for 2015-2017 identified by the LHIC are Behavioral Health, Access to Care, Chronic Diseases (Diabetes, Obesity, Nutrition and Physical Activ-ity), Tobacco Use Prevention, and Oral Healthcare for Adults.

LHIC sub-committees for each focus area have been established and charged with developing and implementing strategies to improve each priority through collabo-ration and partnership.

Community members are welcomed and encouraged to participate with the LHIC on any of the sub-committees to assist with collaborative efforts to improve the health of Wicomico County.