Fort Wayne-Allen County Department of Health...Annual Report 2005 Fort Wayne-Allen County Department...

Fort Wayne-Allen County Department of Health

■ Immunizations ■ Infectious Disease ■ Vital Records ■ STD Clinic ■ HIV/STD Prevention ■ Food Protection

■ Pollution Control ■ Lead Poisoning Prevention ■ Communications ■ Vector Control ■ Laboratory ■ Informatics ■ Finance ■ Emergency Preparedness


1 E. Main St., 5th Floor Fort Wayne, IN 46802 Voice: (260) 449-7561 Fax: (260) 427-1391

www.fw-ac-deptofhealth.com

Deborah A. McMahan, MD Health Commissioner

Mindy Waldron, BS, REHS, CFSP

Department Administrator

Annual Report 2005

http://www.fw-ac-deptofhealth.com/�

Annual Report 2005

Fort Wayne-Allen County Department of Health — 1 E. Main St., 5th floor — (260) 449-7561 — www.fw-ac-deptofhealth.com

Table of Contents PART 1 OVERVIEW Message from the Health Commissioner…………….. 3 Message from the Department Administrator……….. 4 Elected Officials……………………………………… 5 Executive Board of Health…………………………… 6 Organizational Structure……………………………... 7 About the Department………………………………... 8 10 Essential Public Health Functions………………... 9 PART 2 ACHIEVEMENTS/HIGHLIGHTS Communications/Media.............................................. 11 Community Health Nursing........................................ 12 Emergency Preparedness............................................ 17 Food and Consumer Protection.................................. 18 HIV/STD Prevention.................................................. 20 STD Clinic.................................................................. 23 Infectious Disease Center........................................... 26 Informatics.................................................................. 29 Laboratory Services.................................................... 31 Lead Poisoning Prevention......................................... 33 Pollution Control........................................................ 35 Vector Control............................................................ 37 Vital Records.............................................................. 39 Community Partners................................................... 42 State/Local Partnerships.............................................. 43 Financial Statement …………………………... 42

Note: Figures used in this report are based on the best available information at publishing time. This annual report is also viewable online at www.fw-ac-deptofhealth.com.

A Message from the Health Commissioner….

P ublic health has changed dramatically in the last few years, locally and nationally.

From tuberculosis outbreaks to concerns regarding a potential bioterrorism event to preparing for the next influenza pandemic, public

health departments need to be structured to identify and treat infectious diseases, provide routine services such as childhood immunizations, enforce public health laws including restaurant inspections, and now to develop preparedness plans for the unthinkable.

To meet the increasingly complex public health needs of our community, in 2005 we developed and implemented a broad reorganization of our department. We believe we have developed a public health strategy and infrastructure that will better equip our department to meet the ever changing public health challenges of the 21st century.

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Annual Report 2005


A Message from the Department Administrator….

T o be an effective public health agency, we must ensure our program meets the current needs

of the community with respect to communicable disease identification, prevention and education. Further, we must ensure that we are utilizing our limited

resources to the best of our ability to meet those community needs.

In 2005, the Fort Wayne-Allen County

Department of Health underwent a major reorganization which included an in-depth evaluation of each of the department’s 14 divisions and a significant realignment of staff and services. The goal of the reorganization was to allow for more efficient provision of services and to improve the overall productivity levels of the department. Department-wide policies and procedures continue to be developed with the hope of continuing to better structure how the agency operates and improve accountability and quality assurance.

We refer to 2005 as the year of improving the face of public health in Allen County. We look to 2006 as a year of meeting the ever increasing public health challenges that face this community – and we do so with great confidence!

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Board of Commissioners of Allen County

Linda K. Bloom Marla J. Irving F. Nelson Peters Allen County Council Michael W. Cunegin II, 1st District Paula S. Hughes, 2nd District (VP) Darren E. Vogt, 3rd District (P) Calvert S. Miller, 4th District Paul G. Moss, At-large Paulette L. Kite, At-large Roy A. Buskirk, At-large

Mayor of the City of Fort Wayne

The Honorable Graham A. Richard

Fort Wayne City Council

Tom Smith, 1st District Donald J. Schmidt, 2nd District Thomas F. Didier, 3rd District

Thomas E. Hayhurst, MD, 4th District Timothy M. Pape, 5th District

Glynn A. Hines, 6th District Sam Talarico, Jr., At-large

John H. Shoaff, At-large John N. Crawford, MD, At-large

Elected Officials

Annual Report 2005


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Executive Board of Health

T he members of the Executive Board of Health are appointed by the Mayor of Fort Wayne (3) and by

the Board of Commissioners of Allen County (4). The Board’s current membership is as follows:

Gregory S. Schmitt, MD, FACS, President Term expires Dec. 31, 2005

Joseph Steensma, CIH, MPH, Vice President

Term expires Dec. 31, 2006

Terri Y. Farr, RN Term expires Dec. 31, 2007

Anna Lambertson, MD


Richard A. Magley Term expires Dec. 31, 2005

Janet Paunwar


Jay Patel, MD Term expires Dec. 31, 2008

Craig Finlayson, Board Attorney

Paul Moss, Allen County Council liaison Bernie Beier, Mayor’s liaison

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Organizational Chart

BOARD of HEALTH

HEALTH OFFICER

ADMINISTRATOR

COMMUNICATIONS INFORMATICS

FINANCE FOOD PROTECTION

INFECTIOUS DISEASE

HIV/STD PEVENTION STD CLINIC

EMERG. PREPAREDNESS POLLUTION CONTROL

LABORATORY LEAD PREVENTION

COMM. HEALTH NURSING

VECTOR CONTROL VITAL RECORDS

Annual Report 2005

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About the Department

Results at a glance… ■ 6,795 births reported ■ 2,365 food licenses

issued ■ 9,825 doses of

children’s vaccine given

■ 208 health screenings given to newly-arriving refugees

■ 140 mosquito pools tested ■ 279 rabies investigations ■ 11 positive cases of Syphilis ■ 28 cases of HIV reported ■ 705 TB skin tests given ■ 3,602 lead poisoning screenings performed

Most common communicable diseases: ■ Hepatitis C ■ Elevated Lead ■ Hepatitis B, chronic ■ Salmonella ■ Campylobacter


Main Office

1 E. Main St., 5th Floor Fort Wayne, IN 46802

(260) 449-7561

Infectious Disease Center 2040 S. Calhoun St

Fort Wayne, IN 46802 (260) 449-7920

Vector Control

2242 Carroll Road Fort Wayne, IN 46818

(260) 449-7459

Our Mission… To promote and monitor a healthy community by providing effective public health services and working toward a hazard free environment

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1. Monitor health status to identify community health problems 2. Diagnose and investigate health problems and health hazards in the community 3. Inform, educate, and empower people about health issues 4. Mobilize community partnerships to identify and solve health problems 5. Develop policies and plans that support individual and community health efforts 6. Enforce laws and regulations that protect health and ensure safety 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable 8. Assure a competent public health and personal health care workforce 9. Evaluate effectiveness, accessibility and quality of personal and population-based health service 10. Conduct research for new insights and innovative solutions to health problems

The ten essential public health services derive from the core functions and specific responsibilities and form the basis of all public health programs. Assessment: Regular, systematic collection of local and national information to identify important problems Policy development: Setting priorities and developing strategies based on the assessment of health needs Assurance: Assuring that appropriate services are available and accessible to meet the needs of the population

Essential Public Health Functions The Institute of Medicine (IOM) recommends that all communities should have access to these ten essential public health services:

Annual Report 2005


Part II Achievements and Highlights

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Communications/Media

Highlights for 2005 ■ Scheduled or coordinated dozens of media interviews and issued

more than 35 press releases; Also, created a weekly Media Report to inform staff members and Executive Board on all media communications.

■ Created a PowerPoint presentation on HIPAA privacy rules for training purposes

■ Coordinated “Just for the Health of It,” an Allen County employee fitness program; More than 180 people participated and prizes were awarded to top individuals and teams.

■ Co-chaired the Allen County Flu Task Force flu prevention campaign, which included press releases, a website Fighttheflu.org, radio and TV PSAs, billboards, posters, fliers and special events

■ Conducted quarterly updates of the Employee Emergency Contact list and Media contact list; Also, conducted a successful drill of the emergency phone tree.

■ Attended the following training classes: “Laws of Medical Records”; “Pandemic Influenza Preparedness Seminar”; “National WMD Standardized Awareness Program.”

Goals for 2006 ■ Complete and implement the department’s Pandemic Flu

preparedness efforts ■ Develop “Your Health/Your Community,” a program highlighting

important public health issues, to air on public access television ■ Update and expand the department’s website

Hours: M-F 8 a.m. to 4:30 p.m. Voice: 449-7395 Fax: 427-1391

Dir.: John Silcox, BA

Major programs/services: ▪ Media relations/Press releases ▪ Community education ▪ Health Insurance Portability & Accountability Act (HIPAA)

compliance

Annual Report 2005


Goals for 2006 ■ Expand the role of lead case manager in cooperation with the

Childhood Lead Poisoning Prevention Program ■ Fully implement the electronic medical record

■ Work with the Emergency Preparedness Coordinator to refine procedures for mass prophylaxis and/or treatment

■ Continue established programs in the division and in the community

■ Work with community partners to identify health needs of specific populations and develop programs to address the needs

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Highlights for 2005 ■ Participated in the development and implementation of the

electronic medical record ■ Coordinated the City-County Building site for Focus on Health in

April ■ Conducted Flu clinics for the general public January through March

and for city and county employees in November ■ Worked with community partners to provide childhood

immunizations at a Science Central event in September ■ Planned and implemented the “Vaccinate Before You Graduate”

program for high school freshmen and seniors with Super Shot, Inc. and school nurses

■ Provided immunizations to participants to the Healthy Cities Health Fair in November

■ Assisted the Childhood Lead Poisoning Prevention Program with lead screening of preschool children at three day cares in January and February

■ Began to expand the role of lead case management in September

■ Worked with the Emergency Preparedness Officer to develop a plan for a clinic to provide prophylaxis treatment to postal workers exposed to anthrax spores

■ Staffed a clinic set-up to evaluate health needs of Hurricane Katrina evacuees

■ Conducted case investigations on reportable communicable diseases through October

■ Staffed fitness events for the Allen County employee fitness program

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Community Health Nursing Hours: M-F 8 a.m. to 4:30 p.m. Clinic Hours: Monday, Wednesday and Friday 8:30 to 11:30 a.m. 1 to 4 p.m. Refugee health screenings on the first and third Tuesdays Voice: 449-7514 Fax: 449-3996

Dir: Marlene Crouse, BS, MS, RN Staff: Teresa Hope, RN Sally Snyder, RN Patti Easterday, Support Staff Patty Oelkuch, Support Staff

Major programs/services: ▪ Free immunizations to children ▪ Health screenings to newly arriving refugeess ▪ Lead case management ▪ Health education

Annual Report 2005

2004 2005

Childhood Immunizations

DOH

Children seen (# visits) 4,146 3,996

Doses Given 10,163 9,825

Immunization Coverage Levels 51 75

Adult Immunizations

Healthy Cities Health Fair

Flu Vaccine 119 317

Pneumocccal Vaccine 151 186

Tetanus Vaccine 110 148

Flu Clinics

Flu Clinic (City/County employees) n/h* 300

Special Flu Clinics 631 1,784

Disease Prevention – By the numbers

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Hepatitis B-Doses Given 2004 2005

City/County Employees 193 158

INDOT 15 7

Hepatitis B 166 242

Tetanus 154 185

Meningitis 110 167

Refugee Program

Refugees Screened 204 208

Hep B & C blood draws 129 149

RPR 0 70

HIV 129 143

Stool 204 208

TB Screen 204 208

Lead Screen 49 55

Immunizations N/A* 110

Sickle Cell 202 208

Countries of origin: Afghanistan, Azerbaijan, Chad, Congo, Ivory Coast, Kenya, Liberia, Myanmar, Somalia, Sudan, Thailand and Vietnam *N/A=information not available, n/h=no clinic held

2004 2005

Newborn Screens 6 8

Animal Bite Reports 910 716

Public Health Nurse follow-up 8 6

By the numbers (cont’d)

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Annual Report 2005


Reported Communicable Diseases 2004 2005

Campylobacter 29 28 Chickenpox 4 1 Cryptosporidium 2 12 E Coli, 0157(+other) 12 10 Encephalitis, West Nile 1 3 Encephalitis, La Crosse 1 0 Haemophilus B 3 5 Hepatitis A 4 4 Hepatitis B, Chronic 36 62 Hepatitis B, Acute 7 8 Hepatitis C 133 133 Histoplasmosis 8 5 Lead, Elevated 37 95 Legionellosis 3 2 Listerosis 2 1 Lyme Disease 5 6 Malaria 0 1 Meningitis, Aseptic 16 15 Meningtitis, Bacterial 2 1 Mumps 1 1 Pertussis 19 6 Rocky Mountain Spotted Fever 1 0 Rubella 1 1* Salmonella 25 40 Shigella 6 10 Strep Invasive Group A 4 5 Strep Group B Invasive 7 10 Inv Strep Pneumococcol 14 22 Strep Pneu Dr 5 26 Yersinosis 0 1 * Probable case

Lead Case Management (reported by CLPPP)


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Emergency Preparedness

Highlights for 2005 ■ Sent letter of invitation to

approximately 400 religious organizations to invite them to become a CARE (Community Assistance Response and Education) Center in the event of a community medical disaster

■ Assisted the Allen County Medical Reserve Corps with trainings for medical professionals who would be willing to volunteer in a disaster

■ Worked to procure two trailers to be used in medical emergencies using money funded through the Indiana Department of Homeland Security

■ Represented the Health Department on various task forces and work groups (See State/Local Partnerships)

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Goals for 2006 ■ Finalize Mass

Treatment/CARE Centers Protocol

■ Complete Biological Detection System Protocol for the U.S. Post Office


Dir: Kaylene Smith, BS, REHS Staff: Alan Scott, Asst. Emergency

Major programs/services: ▪ Emergency planning ▪ Emergency supply management ▪ Training/drills ▪ Respiratory protection ▪ Air quality issues/Ozone alerts

Annual Report 2005


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Food & Consumer Protection

Highlights for 2005 ■ Presented ServSafe Food Protection Manager Certification Course to

approximately 60 key food protection personnel from area food establishments

■ Sent three division members to the Indiana Environmental Health Association (IEHA) Fall Educational Conference; one attended the IEHA Spring Educational Conference.

■ Participated and attended the IEHA Food Protection Committee Meeting; Division Director also serves on the committee to provide Temporary Food Establishment Guidelines statewide

■ Conducted in-house educational training sessions on the Certification of Food Handler Requirements, Title 410 IAC 7-22, which went into effect Jan. 1, 2005. Educational handouts were also created. Legislation was enacted in April to amend this rule. Again, in-house educational training sessions were conducted and an updated education handout instructed the operators of the changes.

■ Participated as a Division in training with Indiana State Department of Health (ISDH) for foodborne illness investigation and sampling

■ Conducted educational training session with ISDH on Bioterrorism Concerns with the Food Supply

■ Sent a newly-hired Environmental Health Specialist to ISDH Environmental Health Specialist Orientation

■ Established new inspection report and guidelines for Motel and Hotel complaints


Dir: Dawn McDevitt, BS, MS, REHS Staff: Steve Schumm, Asst. Director

Elaine Pruitt, Inspector Jeff Smith, Inspector Mimi Cook, Inspector Rachel Garrison, Inspector Larry Schmoekel, Inspector

Ruby Bates, Support Staff

Major programs/services: ▪ Food establishment inspections/facility plan reviews ▪ Foodborne illness investigations ▪ Food-related consumer complaint investigations ▪ Hotel/Motel investigations ▪ Licensing of Tattoo/body piercing establishments

Food Licenses Issued 2004 2005

Food Service Establishments 1,156 1,203 Food Market Establishments 411 422 Mobile Food Units 120 120 Temporary Food Establishments 604 610 Vending 34 10 Food Inspection Activity

2004 2005

Food Service/Mobile Food Service Estab. 2,275 2,420 Food Market/Mobile Food Market Estab. 863 799 Temporary Food Establishments 1,083 991 Follow-ups/Recalls 164 256 Consumer Food Complaints 392 426 Preliminary Inspections 389 304 Opening Inspections 239 204 Plan Reviews Conducted 37 56 Investigations 106 116 (fire, reportable diseases, operating without a permit) Tattoo/Body Piercing 2004 2005 Establishments Licensed 11 15 Mobile Licensed 1 2 Artists Licensed 48 52 Guest Artist Licensed 1 2 Inspections and Re-Inspections 38 43 Complaint Investigations 4 3 Motel/Hotel Inspections

2005 Complaints 11 Re-inspections 4

Consumer Protection –By the Numbers

Goals for 2006 ■ Update computer software to allow data to be more easily

accessed and compiled ■ Attend FDA training on seafood safe handling

■ Work to increase accuracy and consistency among inspectors

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Annual Report 2005


Highlights for 2005 ■ Increased HIV testing by 23 percent over last year (3,613 HIV tests). The

“Twenty Minute HIV Test” was available in all twenty satellite and clinic testing sites.

■ Made progress on HIV/STD and Hepatitis integration strategy. Currently, Hepatitis B is the only STD preventable by vaccination. More than 1,000 doses of hepatitis vaccine were given to clients seeking other HIV/STD services in 2005. Securing vaccine resources was an on-going project throughout the year.

■ Expanded electronic data collection. The collection of additional CDC data for the web-based data system utilized in the HIV programs was implemented late June. Allen County continued as a pilot site for Indiana State Department of Health’s STD Data Centralization project and the state laboratories’ Docs4Docs program. Preparations for clinic conversion to an electronic medical record system in 2006 were also implemented this year.

■ Received grants for HIV and STD Prevention. Allen County received grants for HIV Counseling/Testing/ Partner Notification Services, STD Prevention, Special Populations and HIV Prevention Case Management for the 2006 programs.

■ Implemented strategies to increase awareness, prevention and testing of Gonorrhea. Gonorrhea cases increased 42 percent over last year in our district. Urine testing is available.

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HIV/STD Prevention

Hours: M-F 8 a.m. to 4:30 p.m. Satellite testing site schedule available on website or call 449-3021 for details of locations and hours Voice: 449-3021 Fax: 449-3507

Dir: Kathy Thornson Staff: Kathy Erick, Disease Intervention Specialist Rochelle Feldheiser, Disease Intervention Specialist Dwight James, Disease Intervention Specialist Pam Sully, Disease Intervention Specialist Hilda Hill, Disease Intervention Specialist Julie Ensley, Support Staff

Major programs/services: ▪ HIV & STD prevention and education

▪ Treatment of known cases ▪ Contact tracing/screening/

case-follow-up to prevent disease spread

Annual Report 2005


Surveillance for DISTRICT 03: Northeast Indiana* 2005 Age Distribution by Disease

*District 03 is the HIV/STD Prevention Programs’ surveillance jurisdiction and is comprised of the following counties: Lagrange, Steuben, DeKalb, Noble, Kosciusko, Whitley, Allen, Wabash, Huntington, Wells, Adams and Jay.

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AGE CHLAMYDIA 2004 2005

GONORRHEA 2004 2005

HIV 2004 2005

P&S SYPH 2004 2005

0 -14 19 24 3 10 0 0 0 0

15-19 766 699 162 219 4 1 1 0

20-24 723 840 183 247 2 4 0 2

25-29 266 352 95 149 3 3 0 1

30-34 82 105 42 59 6 11 0 0 35-39 32 47 28 31 2 6 1 2

40-44 14 15 12 28 10 4 0 1

45 + 13 21 19 24 8 9 0 1

UNK 8 20 1 5 0 0 0 0

2004 TOT. 1,923 545 35 2

2005 TOT. 2,123 772 38 7

% Change 2004-2005

+10%

+42%

+9%

+250%

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STD Clinic

Highlights for 2005 ■ Developed an STD Clinic Policy and Procedure Protocol Manual to

assure the highest quality of care for clinic patients. The manual incorporates Centers for Disease Control and Prevention (CDC) STD treatment guidelines as well as training manuals from various other public health clinics providing similar services.

■ Added an exam room, bringing the total exam rooms to four. In addition, more office space was added to allow separate space for the STD Clinic Director/Staff and the HIV/STD Prevention Director.

■ Participated in several outreach programs in 2005, including: At the Park Center Health Fair, the STD staff offered Hepatitis B Vaccines to participants. Again in 2005, the Clinic participated in the Healthy Cities Health Fair, where indigent women were provided a reproductive health exam. Outreach activities continue to include partnerships with several health care education institutions which offer clinical internships for students.

■ Made progress toward implementing the electronic medical record

■ Experienced an increase in patient visits by 12 percent in 2004 and another 6 percent in 2005

Goals for 2006 ■ Fully implement the electronic medical record to improve quality

assurance measures ■ Provide opportunities for nursing staff to acquire certification in male/

female STD exams through a distance learning course offered by the Cincinnati STD/HIV Prevention Training Center

■ Utilize additional staff through grant funding to increase clinic visits and level of care based on the trend of increasing demand

Dir: Julie Reece, BS, RN Staff: Laura Bartlett, RN Mary Lou Loase, RN Vincent Mendez, Medical Assistant Lisa Little, LPN (p/t) Felicia Nino, Support Staff

Hours: M-F 8 to 11:30 a.m. 12:45 to 4:30 p.m. Voice: 449-7504 Fax: 449-3507

Major programs/services: ▪ Testing

▪ Contact tracing/screening/ case-follow-up to prevent disease

Annual Report 2005


2004 2005 Total STD Visits 5,502 5,822 Total HIV Only Visits 394 335 Total Clinic Visits 5,896 6,157

Female 49% 45% Male 51% 55%

Age Group 15 - 19 16.80% 14.84% 20 - 24 32.60% 31.57% 25 - 29 18.50% 19.57% 30 - 34 10.11% 10.57% 35 - 44 13.55% 13.49% >44 7.78% 9.96%

Race White 51.69% 54.48% Black 39.54% 41.86% Other 8.77% 3.67%

Chlamydia Total Tests 2,857 3,429 Total Positive 506 559 Positivity Rate 17.10% 16.30%

Gonorrhea Total Tests 2,862 3,418 Total Positive 174 253 Positivity Rate 6.10% 7.40%

Syphilis Total Tests 2,636 3,310 Confirmed Positive 4 11 Positivity Rate 0.15% 0.33%

Testing for STDs – By the numbers

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2004 2005 Trichomoniasis 398 358

Bacterial Vaginosis 641 695

Genital Wart Treatment Cryotherapy 129 188 TCA 948 661 Herpes Simplex Virus Total Tests 120 100 Total Positive 53 57

Hepatitis B Total Tests 373 562 Total Positive 3 5

Hepatitis C Total Tests 367 603 Total Positive 23 37

Hepatitis B Vaccine Given First Vaccine 406 599 Second Vaccine 204 255 Third Vaccine 81 152

HIV Total Tests 1,729 2305 Total Positive 15 18


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Annual Report 2005


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Infectious Disease Center

Highlights for 2005 ■ Began operations as the Infectious Disease Center on Nov. 4, 2005 as

a result of the department-wide reorganization to facilitate more effi-cient use of resources. As a result, one RN was relocated to the Infec-tious Disease Center and two new positions for Infectious Disease Specialists were created. In addition to responsibilities for Tuberculosis Control and Prevention, this division is also responsible for the data collection and data analysis related to all reportable communicable diseases.

■ Received a grant from the Indiana State Department of Health to fund one full-time Tuberculosis Outreach Worker

■ Continued to receive assistance from The U.S. Centers for Disease Control and Prevention with the on-going Tuberculosis outbreak; CDC provided an on-site Public Health Advisor from January to November of 2005.

■ Reported a decrease in the case rate for Tuberculosis in Allen County from 7.4 in 2004 to 5.7 in 2005. Although this is a significant decrease, Allen County is still considered a high incidence area within a low incidence state.

■ Reported a 25 percent increase in the number of Directly Observed Therapy (DOT) visits between 2004 and 2005

■ Reported no cases of multi-drug resistant Tuberculosis and only one case of Isoniazid resistant Tuberculosis in Allen County in 2005

■ Implemented a more efficient clinic flow that has allowed for a 30 percent increase in the number of physician visits completed

Hours: M-F 8:30 a.m. to 4 p.m. 1st and 3rd Wednesday, 9:30 a.m.- 4 p.m.

Voice: 449-7920 Fax: 449-3813

Dir: Melanie Koch, BS, RN Staff: Scott Rosheck, RN Lisa Little, LPN (p/t) Audrey Lapsley, Office Coordinator LaQuisha Stapleton, Medical Assistant Phil Steigerwald, Infectious Disease Specialist Cruz Bahena, Infectious Disease Specialist Kenyia Logan, Outreach worker

Major programs/services: ▪ Monitor, prevent and treat reportable communicable diseases

▪ Treatment for active and latent Tuberculosis

▪ Contact investigations

■ Formed a successful partnership between St. Joseph Hospital’s lab and the Health Department in late 2004. The clinic’s satellite lab allows for clients of the Infectious Disease Center to receive lab work necessary for their medical follow-up in a cost efficient manner.

■ Celebrated World TB Day on March 24, 2005 with a well-attended meeting of the Community Infectious Disease Network of Allen County (CIDNAC). Dr. Philip LoBue of the Centers for Disease Control and Prevention provided a lecture on Latent Tuberculosis Infection. Local speakers educated the multi-disciplinary group of health professionals regarding Directly Observed Therapy, Contact Investigation and Isolation.

■ Began working with a group of community Tuberculosis stakeholders, including both Parkview Health Systems and Lutheran Health Network, to create the TB Consortium. This group is creating a plan to train individuals locally to provide Tuberculosis skin testing in a more educational, organized and cost efficient manner than has been available in the past.

Goals for 2006 ■ Continue to identify, effectively treat and cure patients with active

pulmonary Tuberculosis ■ Continue to identify contacts to active cases of Tuberculosis and

provide evaluation and treatment to those with latent Tuberculosis infection

■ Screen high-risk populations and assure that infected individuals are treated to prevent development of active disease

■ Provide timely and thorough investigation and reporting of mandatory reportable communicable diseases

■ Plan and implement innovative efforts to reach non-English speaking populations with latent Tuberculosis infection in need of medical evaluation and treatment in the most efficient and effective way possible

■ Assess communicable disease occurrences for local trends and implement strategies to decrease disease transmission

■ Assist with department-wide plans for emergency preparedness as it relates to communicable diseases and mass contact investigation and treatment

Highlights cont.

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Annual Report 2005


2004 2005 Cases of Tuberculosis

New Cases of Tuberculosis Reported Cases of Tuberculosis Transferred from Another Jurisdiction TOTAL served

24 1

25

20 2 22

Latent Tuberculosis Infection

Individuals Identified and Treated Individuals Identified Previously who remained on treatment in 2005 TOTAL served

N/A*

184 169

353

Physician Visits 824 1,172

Nurse Visits (Estimated)

In Clinic In Field TOTAL

N/A* N/A* N/A*

2,705 180 2,885

Contacts Evaluated 836 342

Tuberculin Skin Testing Contacts Source/Associate Investigation Refugees Targeted Skin Testing Community Referrals for individuals with symptoms or high-risk medical conditions Routine Community Skin Testing TOTAL

836 64 199 113 N/A* 1,113 2,325

320 18 176 72 65 54 705

Satellite Laboratory Services

Clients Visits Specimens Collected

81 125

598 779

Directly Observed Therapy Visits In Clinic In Field TOTAL

774 3,361 4,135

1,279 4,623 5,902

Controlling TB – By the numbers

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*NA = data was not available or collected in 2004

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Informatics

Highlights for 2005 ■ Coordinated the purchase and installation of an electronic medical

records system, created by Medical Informatics Engineering and provided with grants from the St. Joseph Community Health Foundation, for the Refugee Clinic, Lead Poisoning Prevention Program, STD Clinic and Infectious Disease Center; three of the four areas are utilizing the system; the STD Clinic should be using the system by the middle of 2006.

■ Increased the department’s involvement in the Healthcare Access Program (HAP), which was created for “safety net” provider clinics in Allen County to electronically share patient’s health information in a secure manner to provide a continuum of care

■ Created a Health Insurance Portability & Accountability Act (HIPAA) Security Plan for the department, with the assistance of the department’s HIPAA Privacy Officer

■ Utilized GIS to create new inspection districts for the department’s Food & Consumer Protection Division; equalized the number of food establishments for the six inspectors

■ Assisted the Vital Records Division with the installation of Chronica®, a new birth and death record system created by Global Systems

Goals for 2006 ■ To have the STD Clinic utilizing the electronic medical records

system ■ To have the three clinics and one program sharing information with

the HAP group ■ Posting the GPS data of septic systems on the Allen County iMap

website so public will also be able to view locations of septic systems ■ Moving the separate databases of the Food and Consumer Protection,

Laboratory, Lead Poisoning Prevention, Pollution Control and Vector Control divisions into one database

Hours: M-F 8 a.m. to 4:30p.m. Voice: 449-7120 Fax: 427-1391

Dir: Dave Fiess, BS, MPA, REHS Staff: Cindy Wable, GPS (p/t)

Major programs/services: ▪ Develop and maintain surveillance and info. systems

▪ Maintain department website ▪ Utilize GIS mapping

Annual Report 2005


Page Hit Counters* 2004 2005 Index Page 16,444 18,513 Health Professional N/A 837 Applications 967 1,473 Vital Records 4,633 6,635 Communications N/A 2,123 Community Health Nursing 1,889 3,965 Food/Consumer Protection 3,059 5,495 HIV/STD Prevention N/A 1,272 Infectious Disease Center (TB) 1,353 1,931 Laboratory N/A 821 Lead Prevention 138 914 Pollution Control N/A 1,314 STD Clinic N/A 1,770 Vector Control N/A 1,095 Lighten The Load N/A 2,037

TOTAL 50,195

Month Page Views** 2004 2005 January 6,300 9,229 February 7,678 7,798 March 7,434 9,617 April 5,167 9,134 May 5,144 8,169 June 5,144 12,748 July 6,286 11,056 August 6,593 13,952 September 4,851 15,765 October 6,316 18,433 November 6,596 19,379 December 6,203 16,619

TOTAL 73,712 151,899

*Hit Counters count only visitors who enter through the home or index page.

**A Page View is a “hit” counter that only counts the HTML pages, not the graphics. So each request of a page generates an increase of one. This is more accurate than Hit Counters.

Accessing the Web – By the numbers

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Laboratory Services

Highlights for 2005 ■ Participated successfully in

performance evaluation surveys of dairy products, potable water and clinical specimens

■ Hosted survey officers on-site for both dairy product and clinical specimen analysis certification

■ Worked with Pollution Control, swimming pool managers and department administration to initiate phase-out of swimming pool analysis for all but our own inspectors

■ Ended decades of dairy product analysis by this department when the contract with the Indiana State Department of Health was not renewed

■ Began development of a laboratory safety training program to be completed early next year

Goals for 2006 ■ Completing and

implementing the laboratory safety training program

■ Addressing the challenges of adequately staffing the laboratory as a result of downsizing due to the necessary department reorganization

■ Investigating additional analyses that the laboratory may offer to assist inspectors and the public

■ Cooperating further with the STD Clinic in development of more accurate and efficient methods using the new WebChart record-keeping system

Dir: Tom McCue, BS, REHS Staff: Lynn Tucker, Asst. Director Carolyn Chandler, Technician


Major programs/services: ▪ Water sample testing ▪ Cultural and serological analysis ▪ Mosquito assays for Vector Control ▪ E. Coli determinations/dye packet results for

Pollution Control ▪ Other services as requested

Annual Report 2005


2004 2005 CLINICAL ANALYSES: GONORRHEA 4,571 6,290 SYPHILIS 4,204 5,007 BLOOD LEAD 250 29 QUALITY CONTROL 1,722 2,883 STD SEND OUTS/ 4,432 4,997 CHLAMYDIA PROCESSING HIV 2,273 3,839 ADDITIONAL STD'S 1,598 1,652

MILK ANALYSES: BUTTERFAT 515 160 DRUG RESIDUE 525 213 PHOSPHATASE 557 214 COLIFORM 1,263 539 HETEROTROPHIC PLATE COUNT 1,223 450 ANCILLARY TESTS 271 107

WATER ANALYSES: POTABLE 863 509 NON-POTABLE 2,510 1,154 POOLS 6,335 5,660 HETEROTROPHIC PLATE COUNT 5,932 5,931 CONFIRMATORY TESTS 994 378 PLATED MEDIA PREPARATION 11,549 12,849

QUALITY CONTROL TESTS: 11,225 7,783

FOOD COMPLAINT ANALYSIS: 23 15

POLLEN COUNTS: 31 0

MOSQUITO POOLS: 215 121 TOTALS 63,081 60,780

Laboratory Analysis – By the numbers

32 33

Lead Poisoning Prevention

Highlights for 2005

■ Developed and launched a public awareness campaign that included posters, brochures and four billboards positioned in at-risk neighborhoods.

■ Hired a part-time phlebotomist to screen at-risk children in the community for lead-poisoning, using a grant from Parkview Community Health Improvement Program

■ Screened 1,252 children at various sites including the Welfare Department, South Anthony Super Shot Clinic, various Fort Wayne Community Schools and several Head Start programs

Goals for 2006

■ Retain key personnel and increase needed resources

■ Enlist the support of community partners to meet the Elimination Plan goals

■ Ensure that lead poisoning is understood by the targeted community audiences (parents, property owners, real estate agents and brokers, contractors, educators and health professionals) and policy makers

■ Assist individuals/contractors/landlords to assess whether there are lead hazards in their homes/houses and educate them on the best strategies or practices that remediate or abate the lead hazards

■ Mitigate the physical and mental consequences of lead poisoning through effective case management

Dir: Amy Hesting, BS, REHS Staff: Nicole Gaunt, Case Manager Loaine Hagerty, Program Coordinator Ron Lipinski, Inspector (p/t) Cindy Wable, Env. Tech. (p/t) Barb Owen, Support Staff Kristi Hughes, Phlebotomist (p/t)

Hours: M-F 8 a.m. to 4:30p.m. Voice: 449-8600 Fax: 427-1391

Major programs/services: ▪ Lead case management ▪ Risk assessments ▪ Samplings/inspections ▪ Education/prevention

Annual Report 2005

2004 2005 Screening work

Total screening 2,254 3,602 Routine screening 2,254 2,350(immunization clinic & doctors) Targeted screening N/A 1,252

Number of children diagnosed 43 95 with Elevated Blood Lead Level Case management work Number of case management activities 881 1,254 Outside referrals made 44 49 Developmental assessments 15 10 Family assistance (hours) 87 134 Environmental lead work Lead risk assessments, inspections 54 70 re-inspections & samplings Lead complaint investigations 1 3 General lead work Lead education & outreach activities N/A 163 General lead work (hours) 749 1,189 STELLAR work (hours) 192 231 Lead information given to the 137 190 public through referrals or requests Grant proposals submitted 2 6 Grants received 2 3

Lead Program – By the numbers

34 35

Pollution Control

Highlights for 2005 ■ Continued implementation of

the onsite sewage disposal surface discharge system permit program

♦ Inspected the installation of the first five surface discharge systems on existing homes with no other solution

♦ Continued the implementation of the Allen County Onsite Wastewater Management District in order to utilize this permit

■ Continued mapping onsite sewage disposal systems with Global Positioning System (GPS) equipment

♦ All components of newly installed onsite systems are documented in the field using GPS equipment

♦ Nearly completed mapping visible components on all systems installed since 1990

■ Started utilizing Geographic Information System (GIS) maps for site evaluations

■ Modified Public Swimming Pool Ordinance to eliminate department collection of water samples

Goals for 2006 ■ Reduce open sewage

complaints by 50 percent ♦ Educate homeowners on

problems and solutions ♦ Improve enforcement

follow-up ■ Improve public swimming

pool operators’ performance ♦Educate operators on

sampling and logging requirements

♦Follow-up with test strips and log checks

■ Complete inventory of onsite systems without permits

■ Distribute criteria for onsite system inspection and operating permit renewal

Dir: Gary Chapple, BS, REHS Staff: Mark Herber, Assistant Director

Kathy Doseck, Plan Review Coord. Jack Gensic, Inspector Ron Lipinski, Inspector (p/t) Ray Navarro, Env. Tech. Susan Depp, Support Staff Supvs. Jennifer Gregory, Support Staff


Major programs/services: ▪ Inspecting septic systems ▪ Mapping septic systems ▪ Investigating sewage complaints ▪ Swimming pools/spas sampling

Annual Report 2005


2004 2005 Construction Permits Issued 239 238 Inspection/New Installs/Initial 252 256 Inspection/New Installs/Re-inspection 942 931 Inspections/Existing Systems 236 167 Operation Permits 245 172 Sewage Complaints/Inspections 104 92 Sewage Complaints/Re-inspection 192 164 Dye Tests 25 25 Orders to Correct Faulty Systems 33 45 Miscellaneous Complaints/Investigations 775 561 Phase I Investigations 178 146 Public Sewer Connections 100 150 Potable Water Samples 0 0 Outdoor Air Samples 3 0 Burning Investigations 2 0 Underground Storage Tanks (UST’s) 0 0 Pool / Spa – Education 24 5 Pool / Spa – Inspection 251 276 Pool / Spa – Re-inspection 437 475 Pool / Spa – Complaint 17 7 Pool / Spa – Water Samples 5,457 5,059 Lab Samples 630 109 GPS Mapping/Initial Visit 1,179 839 GPS Mapping/Revisit 179 218 Site Assessments 113 142 Soil Wetness Tests/Initial Test 334 217 Soil Wetness Tests/Retest 275 212 TOTALS 12,222 10,506

Pollution Control – By the numbers

36 37

Vector Control

Highlights for 2005 ■ Eliminated one rodent

technician position due to department reorganization

■ Created the position of Neighborhood Improvement Coordinator. This position is responsible for complaints dealing with unsanitary living conditions, adult and child endangerment, roaches, fleas, trash, noxious odors, abandoned refrigerators and mold

Dir: Loren Eck, BS, REHS Staff: Leonard Young, Rodent Tech. Ray Capps, Env. Tech. Support Staff (p/t)

Hours: M-F 8 a.m. to 4:30 p.m. Voice: 449-7494 (Rats, Rabies) 449-7459 (Mosquitoes) Fax: 449-7460

Major programs/services: ▪ Mosquito surveillance/control ▪ Rodent control by means of poison bait placement ▪ Animal bite investigations when rabies transmission is

implicated ▪ Environmental nuisance complaints

Goals for 2006 ■ Provide both technicians with

enough hands-on experience to pass licensing test and become registered technicians

■ Reduce vehicle accidents within summer mosquito crew by stressing safe driving practices

Annual Report 2005


Rodent Data 2004 2005

Initial Complaints 911 906 Initial Surveys 861 845 Recall Inspections 1,142 959 Recall Surveys 1,123 892 Alley Surveys 1,187 809 Door Hangers 298 271 Bait Used 8,754 6,381 Trash Referrals 57 134 Legal Notifications 510 226 Fines 25 9 Court Summons 22 4

Mosquito Data Citizen Complaints 407 64 Breeding Site Inspections

3,536 2,773

Breeding Sites Treated 1,250 637 Mosquito-fish Sites 125 139 Catch Basins Treated 3,350 3,350 ULV Fogging (miles) 8 16 Mosquito Pools Tested 221 140

Rabies Data Rabies Investigations 198 279

Environmental Environmental complaints

134

Vector Control – By the numbers

38 39

Vital Records

Highlights for 2005 ■ Installed first version of Chronica® software, which replaced five

existing programs used to issue, amend and store birth and death certificates and related documents

■ Hosted Indiana Vital Records Association fall conference held at the Fort Wayne Hilton Hotel

■ Started scanning death records into our digital system of preserving records

■ Participated in “Drive Alive” campaign, a community-wide task force to reduce teen deaths

■ Continued to attend Joint Application Design meetings to assist Indiana State Department of Health in developing a Web-based computer program

Dir: Janet Westendorf Staff: Sarah Castillo, Asst. Director Kristi Gephart, Clerk

Alexis Shoda, Clerk Bonnie Williams, Clerk


Major programs/services: ▪ Filing birth/death records

▪ Issuing certified birth/death certificates ▪ Preparing/filing Paternity affidavits

▪ Receipt of adoption records ▪ Birth record changes by court order ▪ Verifying birth/death information for government entities

Annual Report 2005


DEATHS (cont’d) Causes (Coroner)

2004 2005

Accident 193 195 Homicide 28 32 Suicide 37 40 Sudden Infant Death 4 4 Undetermined 15 7 TOTAL DEATHS 3,242 3,429 Resident of Allen County 2,337 2,531 Non-Resident 905 897 Fetal Deaths 47 38 Male 1,606 1,768 Female 1,636 1,660

Location of Death

2004 2005 Lutheran Hospital 556 623 Parkview North Hospital 16 19 Parkview Main Hospital 767 799 St. Joseph Hospital 184 186 Dupont Hospital 14 16 Veterans Administration 32 38 Hospice Home 239 286 Residence, nursing home, other 1,447 1,500

Deaths by Age Group

2004 2005 Under 28 days 52 48 29 days to 1 year 12 17 1 year to 14 years 22 28 15 years to 24 years 54 51 25 years to 44 years 144 186 45 years to 64 years 650 694 65 years to 74 years 602 632 75 years to 84 years 908 937 85 years and over 798 835


41

BIRTHS Hospital and Home Delivery

2004 2005 Lutheran Hospital 1,717 1,577 Parkview North Hospital 791 809 Parkview Main Hospital 1,882 1,720 St. Joseph Hospital 537 505 Dupont Hospital 1,876 2,144 Home Births 35 39 In route to hospital 0 1 TOTAL BIRTHS 6,838 6,795 Resident Births 5,221 5,202 Non-Resident 1,618 1,593 Paternity Upon Marriage 103 140 Correction Affidavits 98 100 Revenue Collected $359,952 $419,357 Born to married parents Male 2,318 2,301 Female 2,171 2,139 Unmarried parents Male 1,181 1,198 Female 1,169 1,156

DEATHS Causes (Medical)

2004 2005 Heart Disease 714 698 Cancer 711 781 Apoplexy 195 196 Pneumonia 205 246 Diabetes 87 100 Cirrhosis 31 53 Chronic Obstructive Lung Disease 140 149 Premature Infant 34 33 HIV/Aids 11 7 Influenza 2 10 Tuberculosis 1 2 All Other Causes 645 973

Vital Records – By the numbers

40

Annual Report 2005


42

Healthcare/Social Service Agencies AIDS Task Force Allen County Suicide Prevention

Council American Red Cross Associated Churches of Fort Wayne

and Allen County Catholic Charities Center for Behavioral Health Center for Nonviolence Community Action of Northeast

Indiana Community Harvest Food Bank First Steps of Allen County Fort Wayne African-American

Cancer Alliance Fort Wayne Downtown Rotary Club Fort Wayne Housing Authority Fort Wayne Medical Education

Program Fort Wayne Medical Society Fort Wayne Rescue Mission Fort Wayne Women’s Bureau H.A.N.D.S Habitat for Humanity Health Vision Midwest Healthier Moms and Babies Lutheran Social Services of Indiana March of Dimes McMillen Center for Health

Education Planned Parenthood of Greater

Indiana Retired and Senior Volunteer

Program (R.S.V.P.) St. Joseph Community Health

Foundation

Three Rivers Ambulance Authority

United Way of Allen County Up the Stairs Community Center Washington House Treatment

Center Wayne Township Trustee YMCA Women’s Shelter Hospitals/Health Clinics ASK Clinic Lutheran Health Network Matthew 25 Health and Dental

Clinic Neighborhood Health Clinics Park Center Parkview Health RediMed Super Shot, Inc. Schools/Universities East Allen County Schools Fort Wayne Community Schools Indiana-University, Purdue-

University, Fort Wayne Ivy Tech Community College Northwest Allen County Schools Southwest Allen County Schools University of Saint Francis

Community Partners The department relies on the cooperation and resources of many other agencies and organizations in Allen County in order to fulfill its mission of providing the most effective delivery of public health services to our com-munity. We thank them.

43

Local/Regional Allen County Citizen Corps Allen County Data Board Allen County Disaster Mental Health

Team Allen County Flu Task Force Allen County Human Resources Safety

Committee Allen County Medical Reserve Corps Allen County Pandemic Flu Task Force Allen County Partnership for Water

Quality board (ACPWQ) Allen County Regional Water and Sewer

District board (ACRWSD) Allen County School Safety

Commission America on the Move Community Infectious Disease Network

of Allen County (CIDNAC) Core Refugee Services meeting Covering Kids Task Force District 3 Hospital/Health Department

Planning Committee Drive Alive Steering Committee First Steps Council Focus on Health Girl Scouts of Limberlost Council Great Kids Make Great Communities Habitat for Humanity family selection

committee Health Advisory Board (Head Start) Health is the Key to My Heart Healthy Cities Homeless Task Force Interagency Council on Housing and

Homeless Issues Kids-Safe Network Northeast Indiana AIDS Memorial Northeast Indiana AIDS Walk Steering

Committee Northeast Indiana Environmental Health

Association Media Wise Steering Committee

Ozone Task Force Safe Kids Sexual Assault Treatment Center

Board Success by Six Suicide Prevention Council TB Consortium (Lutheran/Parkview) Watershed Team meetings World AIDS Day planning

committee State Indiana Environmental Health

Association (IEHA) Wastewater Management Committee Food Protection Committee

Indiana Family Health Council Indiana Methamphetamine Task

Force Indiana State Department of Health

(ISDH) GenesisTeam ISDH Bioterrorism Advisory

Committee ISDH Environment and Housing

subcommittee ISDH HIV/STD Prevention ISDH Mass Prophylaxis Work

Group ISDH Risk Assessment Format

Protocol group Indiana Vital Records Association Indiana Vector Control Association Lead-Safe Task Force Maumee River Basin Partnership of

Local Governments (MRBPLG) Vaccinate Before You Graduate

State/Local Partnerships In addition to internal operations, the department’s administrative and professional staff participate on various state and local task forces, standing meetings and committees, coordinating councils and interagency groups.

Annual Report 2005


Beginning Balance Jan. 1, 2005 $947,094.74 $927,783.98

Revenue 4,656,600.62 3,447,399.07

5,603,695.36 4,375,183.05

Disbursements 4,675,911.38 3,149,502.89

Balance Dec. 31, 2005 $927,783.98 $1,225,680.16

2004 2005 Financial Statement

REVENUE SOURCES 2004 2005

General Property Taxes $2,849,840.14 $2,160,075.76

Excise Tax 236,916.07 200,403.33

Financial Institution Tax 21,750.35 9,354.00

Commercial Vehicle Excise Tax 34,909.99 17,028.74

44

Finance Division

Dir.: Carol Gigli, BS Staff: Penni Moran, Payroll Admin. Loretta Foy, Administration (p/t) Joanna Baker, Support Staff


Major programs/services: ▪ Oversee all expenditures, disbursements and receipts for the department ▪ Ensure compliance with guidelines for expenditures set forth by Allen County Council, Board of Commissioners of Allen County and the Indiana State Department of Health ▪ Keep all personell, payroll and attendance records for the department’s 65 full-time employees

REVENUE SOURCES (Cont’d) 2004 2005

Bond Bank Borrow 114,007.00 0.00

Fees (See Addendum # 1) 927,449.22 1,034,940.26 Misc. Fees (See Addendum #2) 9,459.62 7,225.39 Interest 6,169.99 18,245.75 HIV/AIDS Substance Abuse Grant 74,834.19 0.00 Bioterrorism Grant 25,600.00 0.00 STD Grant 143,565.23 0.00

HIV/AIDS Education Grant 132,098.55 0.00 Pocket of Needs 29,435.15 0.00

Nurse Survey 5,000.00 0.00 Infectious Disease Clinic 7,654.62 742.71

TB Educational Grant 18,000.00 0.00 Community Immunization Program 20,000.00 0.00

Adjustments -89.50 -616.87

TOTAL $4,656,600.62 $3,447,399.07

45

FEES (ADDENDUM #1) 2004 2005 Vital Records $359,975.80 $368,293.41 Food Permits 415,697.39 413,331.05 Swim. Pool Permits 63,545.00 144,542.50 Water Tests 5,958.00 8,982.00 Septic Fees 30,225.00 28,125.00 Vaccinations 22,308.03 48,860.30 Dairy Tests 24,500.00 17,356.00 Tattoo 5,240.00 5,450.00 TOTAL $927,449.22 $1,034,940.26

* **

*An additional $22,932.00 was collected in 2005 from Vital Records which is State mandated to the Coroner Continuing Education Fund. **An additional $72,940.73 was collected in 2005 from Food Permits. By local Ordinance, these funds are set aside to help support a food inspector on the Local Health Maintenance Fund.

Annual Report 2005

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MISCELLANEOUS REVENUE (ADDENDUM #2) 2004 2005 Travel Reimb./Refunds/ $9,459.62 $7,225.39 West.Nile Virus Reimb. TOTAL $9,459.62 $7,225.39

*An additional $22,932.00 was collected in 2005 from Vital Records which is State mandated to the Coroner Continuing Education Fund. **An additional $72,940.73 was collected in 2005 from Food Permits. By local Ordinance, these funds are set aside to help support a food inspector on the Local Health Maintenance Fund.

2004 2005

DISBURSEMENTS Department of Health $3,763,380.99 $2,833,824.70 Bank Bond Payment 114,007.00 0.00 Vector Control 76,389.95 61,198.90 HIV Substance Abuse Grant 71,366.70 300.00 S.T.D. Grant 146,324.80 996.00

I.D.C. (formerly TB Clinic) 152,071.88 192,594.68

HIV Education Grant 142,122.14 38,371.13

Community Immunization Grant 27,105.33 0.00

Tobacco Master Plan 90,825.36 12,238.56 Positive Project 5,597.63 4,482.37 Nurse Survey 4,999.98 0.00

St. Joseph Comm.Found. Grant 39,064.66 100.00

TB Education Grant 9,272.57 5,918.80

Pocket of Needs Grant 16,273.79 0.00

Bioterrorism Grant 17,108.60 503.48

3/31/05 Correction/disbursed wrong fund 0.00 (104.17)

11/31/05 Correction/disbursed wrong fund 0.00 (921.56)

TOTAL $4,675,911.38 $3,149,502.89

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MISCELLANEOUS GRANT TB Emergency Grant $27,860.26

Tobacco Master Plan 77,123.96

St. Joseph Comm. Found.Grant 52,425.33

Public Health Coordinator Grant 20,521.36

TB Block Grant 57,802.91

2005

2004 2005

FINANCIAL REPORT

LOCAL HEALTH MAINTENANCE FUND Beginning Balance, Jan. 1, 2005 $203,568.94 $212,713.08

Receipts State Fund 50,000.00 50,000.00

Tobacco Settlement Monies 34,008.00 20,128.48

Interest 3,545.51 6,872.75

Fees - Food Permit 73,358.35 72,940.73

$364,480.80 $362,655.04

Disbursements -151,767.72 -119,687.65

Investments 0.00 0.00

Balance, Dec. 31, 2005 $212,713.08 $242,967.39

IMMUNIZATION DONATION FUND Balance, Jan. 1, 2005 $5,331.35 $6,384.15

Donations Received 5,933.82 6,830.00

11,265.17 13,214.15

Disbursements -4,881.05 -483.00

Balance, Dec. 31, 2005 $6,384.12 $12,731.15

Annual Report 2005


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STD CLINIC DONATION FUND Balance, Jan. 1, 2005 $12,491.89 $11,167.86

Donations Received 3,394.46 4,569.74

15,886.35 15,737.60

Disbursements -4,718.49 -7,009.78

Balance, Dec. 31, 2005 $11,167.86 $8,727.82

SMALL POX FUND Receipts $4,489.08 $138.81

Disbursements -4,350.27 -138.81

Balance, Dec. 31,2005 $138.81 $0.00

ALLEN COUNTY WASTE WATER MANGT.

Balance, Jan. l, 2005 $0.00 $11,865.39

Receipts 11,850.00 47,200.00

Interest 15.39 972.50

Disbursements 0.00 -50.00

Balance, Dec. 31, 2005 $11,865.39 $59,987.89

2004 2005

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