Program Implementation Plan Results: 4th Quarter, …...2019/01/08 · Monitored timely reporting of notifiable/reportable diseases, lab test results, and investigation results (Measure

Program Implementation Plan Index

12

7

543

Harm Reduction Program

Emergency PreparednessEnvironment HealthDisease Prevention

Division / ProgramHealth Promotion and EducationPlumbing

11

21

Performance Management Work Groups

This Program Implementation Plan outlines the actions, outputs and outcomes that will be accomplished by HCPH

divisions during 2018. It assigns responsibilities and dates for the work to be completed. Output targets are determined

by 2017 output data or grant, contract, and state administrative guidelines. This plan was developed by directors and

staff, reviewed by the Plan of Work Workgroup and approved by the Performance Management Council and Hamilton

County Board of Health.

0 Road Block | Postponed Road Block: Not progressing as anticipated; Re-prioritized.

6 Epidemiology 13 Performance Management Action Items

Program Implementation Plan Agency Narrative

Hamilton County Public Health staff had a successful 2018. The year completed with 56 percent of metrics as

"Exceeding | Complete." There were 41 percent of metrics that were "On Track | Performing as Needed." There

were four metrics or three percent of metrics that were identified as "Behind | Unfavorable."

Overall, several major accomplishments include the implementation of the Oral Health Coalition, successful first

year of the Harm Reduction program, and a significant increase in permitting and licensing inspections. Staff

successfully completed several grant and contract requirements and were able to begin new grant and contract

cycles with new deliverables and requirements.

A more detailed review of accomplishments by divisions and programs follows.

Waste ManagementWater Quality

Page

Program Implementation PlanResults: 4th Quarter, 2018

4 Behind | Unfavorable Behind|Unfavorable: Currently behind anticipated progress.

77 Exceeding | Complete Exceeding | Complete: Currently above benchmark or completed.

On Track|Performing as Needed: Progressing as anticipated.

Program Implementation Plan Agency Summary

57 On Track | Performing as Needed

10

Page

Strategic PlanAdministrationDivision / Program

89

G. Varner

G. Varner

G. Kesterman

G. Kesterman

T. Ingram

T. Ingram

C. Davidson

M. Samet

M. Samet

G. Varner

G. Varner

S. Taylor

S. Taylor

M. Samet

M. Samet

4th Quarter2018

7 Exceeding | Complete Exceeding|Complete: Currently above benchmark or completed.


ADMINISTRATION

Programs NarrativeAdministration has successfully finished 2018 with all 15 tracked programs and activities as "On Track | Performing as Needed" or "Achieving | Exceeding." Customer Service and Vital statistics had a record year issuing nearly 63,000 permits, licenses, and certificates in 2018. This exceeds three-year benchmarks by 8,400. The 2019 licensing activities have started -- this time with an even greater emphasis on online ordering. All required benchmarks for accreditation have been completed and work has started for the first quarter submission of our accreditation annual report. Assignments have been made for the reaccreditation process that will be completed in 2022. Administration is also on track with all required reports tracked in the Program Implementation Plan.

8 On Track | Performing as Needed On Track|Performing as Needed: Progressing as anticipated.


Programs

Number of death certificates issued 226,450 7,441 6,331 6,259 6,401 100%

% Complete YTD Status

Number of birth certificates issued 215,813 3,354 4,614 4,184 3,372 98%

Customer Service & Vital Statistics 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

Number of EHS licenses issued 23,936 2,605 1,009 240 127 101%

Number of EHS permits issued 18,254 3,831 4,698 4,802 3,580 205%


Number of Board of Health training hours 12.00 1.00 0.50 0.83 0.00 117%

Board of Health Training Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Status

Annual accreditation report created and submitted 1Yes

Accreditation

Human Resources - Number of new hires that have completed orientation 2100% 6 4 5 4 100%


Finance - internal reports, audits, and budgets complete (25% indicates quarter complete) 2100% 25% 25% 25% 25% 100%

Administration Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Monitored timely reporting of notifiable/reportable diseases, lab test results, and investigation results (Measure 2.1.5A) 1YesA system to receive and provide urgent and non-urgent health alerts and to coordinate an appropriate public health response (Measure 2.4.2 A) 1

2 4 2 3 YesTests Completed by Quarter:

Emergency Communication - Quarterly review, update, and test of emergency preparedness contacts and lists 18 2 4 2 3 100%

Human Resources - Number of HCPH personnel policies reviewed 275 19 19 19 18 100%Public Information - HCPH share of voice (comparing Cincinnati Health and Northern Kentucky communications) 150% 69% 73% 39% 60% 60%

Implement culturally competent initiatives to increase access to health care services for those with barriers due to cultural, language, or literacy (Measure 7.2.3 A) 2In Progress

Finance - Grants - required meetings, budget and expenditure reports complete (25% indicates quarter complete) 2100% 25% 25% 25% 25% 100%

Page 1

G. Kesterman

C. Davidson & R. Stowe

L. McCreadie

B. Stowe

B. Stowe

B. Stowe

T. Ingram

T. Ingram

1

Programs

2

1

Selected materials distributed and posted In ProgressPublic Information - Survey key audience groups (M. Samet) Yes

1

In Progress

Mental Health

Status

Manage Harm Reduction program and report on key program metrics (See Harm Reduction page for details) 1

HCPH STRATEGIC PLAN

Update communications plan based on input from surveyed groups YesEmergency Preparedness - Update staff training plan as needed to ensure emergency readiness (J. Sherrard) Yes Implement emergency readiness training plan as needed for staff Yes

Information Technology - Assess division and agency needs (E. Moser) Yes Develop response plan

4th Quarter2018



Programs Narrative

HCPH staff successfully accomplished in 2018 all requirements for year two of the HCPH Strategic Plan. There continues to be significant progress with the newly implemented Oral Health Coalition. An action plan is being formulated and fundraising opportunities are being considered. HCPH has made significant progress in the substance abuse initiative with the Harm Reduction Program now being fully operationalized. For additional details, see page 9 of the Program Implementation Plan. The Public Information Officer has continued to work with the Customer Service Feedback Workgroup and is creating content for key audience groups with the intention of updating the communications plan based on feedback received. There have been several improvements to service delivery, including improvements in interpretations services, signage, and multilingual access points on our website.



Support and collaborate with partners in youth suicide prevention workgroup. 2In Progress

Status

Coordinate response to condemnations and difficult housing nuisances to assist in finding long term solutions 2

Yes

Substance Abuse

Status

Target schools identified, school implementation launchedYes

Obesity

Yes

Program outcomes developed and data points determined 1Yes

Yes

Evaluation plan developed

Status

Select coalition members, coordinator and convene coalition 2

Oral Health

1

Action plan developed and report on progressIn Progress

Complete report showing status of positions and support of new workloads Yes

Yes Messages identified and developed YesService delivery - Languages, signage and printed materials identified (M. Samet)

In Progress

StatusAdministrationWorkforce - Assess capacity (S. Taylor)

Page 2

DISEASE PREVENTION 4th Quarter2018


STD Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD Status


Program NarrativeThe Division of Disease Prevention exceeded or performed as needed for 7 of 10 performance metrics in 2018. Two immunization program metrics fell short of benchmarks, and although there were fewer congenital syphilis cases reported than in 2017, the target of a 50% reduction in cases was not met. A quality improvement project to be implemented in 2019 will address immunization program improvements and work has been initaited to review each congenital syphilis case with healthcare system partners. The Division experienced challenges due to staffing shortages and a transition in leadership in Q1 and Q2. Staffing levels have improved significantly during of Q3/Q4 and metrics have also improved. Q4 has seen increased nursing activity in administrating vaccines, particularly vaccines for hepatitis A and influenza. We are currently in process of filling vacant positions in TB and HIV/STD, and anticipate all vacancies to be filled in Q1 of 2019. Several HIV/STD metrics were challenging due to difficulities in locating partners of diagnosed cases. This is the result of the rising prevalence of dating apps that allow individuals to meet anonymously as well as patients that are transient/experiencing homelessness. The immunization program is continuing to be refined and expanded, and new standard operating protocols are being adopted with the assistance and approval of Dr. Steve Feagins MD, HCPH Medical Director. In addition to opportunities identified in the quality improvement project, these protocols will ensure metrics are on track and provide for increased efficiency in billing. Hepatitis A vaccines have been provided to the community through doses provided by HCPH DP staff at the Hamilton County Justice Center, on The Exchange Project, and other community sites. Additional new protocols are also being written for TB and HIV/STD that will ensure performance objectives will continue to be met in the future, and will provide a good foundation as we build and expand programs. CMH has also refined processes and is moving forward nicely with a full time staff person now on board.




25 % of eligible families are contacted each quarter (quarter reported in % contacted; Approximately 1,100 patients annually)125% 15% 45% 75% 90% 90%

Children with Medical Handicaps Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs

Minimum of 75% of infected contacts complete treatment each quarter (Approximately 25 patients annually) 175% 80% 80% 85% 85% 85%


All active TB cases managed in compliance with current CDC guidelines (Approximately 200 patients annually) 1100% 50% 75% 90% 100% 100%

Tuberculosis Control Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4


Increase from 71% to 76% of two-year olds appropriately immunized (Metric determined by ODH annual audit standards in Q3) 376% NA NA NA 64% 64%

Immunizations Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

70% of clients seen during annual influenza season receive recommended influenza vaccine (Approximately 520 patients annually) 270% 64% NA NA 74% 72%

Decrease from 13% to 10% in missed opportunities to immunize (Metric determined by ODH annual audit standards in Q3) 310% NA NA NA 18% 18%

All services compliant with VFC program guidelines and ACIP recommendations 1100% 90% 100% 100% 100% 100%

Continuous Quality Improvement Current Projects New Projects Identified

5 0 0 1 3 80%

13 of 13 grant metrics are meeting or exceeding required targets 213 13 12 12 11

The division has identified two projects to be initiated in 2019 which will also support completion of objectives in the 2018-2020 Community Health Improvement Plan. The projects will be focused on identifying improvements in the immunization and pedicatric case management programs.

No Yes

7 of 7 grant metrics are meeting or exceeding required targets 27 7 6 6 6 86%50% reduction in incidence of congenital syphilis cases. Goal is zero cases. (3-Yr Avg.) 3

85%

HIV Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD Status

Page 3

112 0 24 0 0 200%

Number of public swimming pool and spa inspections completed 11,272 42 850 631 87

Status

Food Safety and Education Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD

Number of people educated (Goal) 21,400 379 252 266 265 83%

Status

Number of FSO / RFE inspections completed 26,442 1,219 1,634 1,881 1,118 91%

4th Quarter2018


Programs NarrativeThe Division of Environmental Health completed 2018 with all 14 metrics exceeding or performing as needed. Food inspection numbers finished the year with 90.8 percent complete. The balance of food inspections will be completed in the first two months of 2019 - licensing runs March 1, 2018 through February 28, 2019. Food education numbers are slightly lower than the benchmark. This is due, in part, to the number of participants that took the course immediately after the state law change that required food education participation. The EH Division has expanded education to Public Health-Dayton Montgomery County offering two classes in 2018. Staff continued to promote the educational courses within all food facilities during inspections. Pools and nuisance inspections have increased throughout 2018 as the result of follow-up and complaint inspections. Staff have continued to respond to complaints within an average of two business days. Campground and school inspections remained at benchmark levels throughout 2018. An addition of three new primitive camps are expected to be licensed in 2019.


0 Behind|Unfavorable: Currently behind anticipated progress.


ENVIRONMENTAL HEALTH

Behind | Unfavorable

Programs

Number of facilities that are brought through the enforcement process (3-Year Avg.) 245 14 14 11 5 98%

Average number of days to respond to complaint (Requirement) 13 2 2 2 2 100%


Number of housing inspections completed 21,546 399 505 635 437 128%

Housing and Nuisance Inspections 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

% Complete YTD

127%Number of individuals and facilities in attendance at annual swimming pool educational course (3-Year Avg.)

Public Swimming Pools and Spas Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD

Campground Inspections - Number of standard inspections conducted 120 0 8 5 10 115%

Status

School Inspections - Number of standard inspections conducted 2344 18 156 2 137 91%

Additional Inspection Programs Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Manufactured Home Parks - Number of contract inspections conducted 186 0 84 2 0 100%

Public Accommodation Facilities - Number of standard inspections conducted 1126 54 30 3 99 148%


The Division has completed two CQI projects for 2018. The first project involved improvements in the equipment replacement notification process for public swimming pools. The second project relates to online payments for all EH programs. The project focused on improvements to web payments. Data will continue to be gathered throughout the 2019 licensing period to see if the change resulted in an increase for online purchases.

Yes No

Smoke Free Ohio - Number of inspections conducted (3-Year Avg) 251 11 8 4 11 67%

Rabies Prevention and Control 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4 Status

Number of quarantine notices sent 2765 137 178 215 154 89%Number of samples sent to the Ohio Department of Health for testing 278 16 20 28 19 106%

Page 4

14 1 1 1 1 100%

4 1 1 1 1 100%

Accreditation Standard 1.2.1 (24/7 communication; Requirement)

4 1 1 1 1 100%Complete 1 per quarter after hour check on HCPH fax system

Local PHEP Grant (BP2: ’18-’19) - # of deliverables completed (grant begins 7/1/18)

% Complete YTD

2018-2019 Grant - # of deliverables completed (grant begins 7/1/18)

112 NA NA 6 6 100%Regional PHEP Grant (BP1: ’18-’19) - # of deliverables completed (grant begins 7/1/18) 15 NA NA 3 2 100%


There have been no current or planned quality improvement projects identified. No No

# of POD drills/exercises completed 13 1 2 2 3 267%

Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD Status

Complete 1 per quarter after hour checks on HCPH phone system 1

Complete 1 per quarter after hour check on HCPH website 1

Status

# of POD orientation trainings completed 15 13 10 2 4 580%

Points of Dispensing (POD) Sites Goal Quarter 1 Quarter 2 Quarter 3 Quarter 4

13 NA NA 1 2 100%


2017-2018 Grant - # of deliverables completed (grant ends 6/30/18) 14 0 4 NA NA 100%

Cities Readiness Initiative Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Regional PHEP Grant (BP1: ’17-’18) - # of deliverables completed (grant ends 6/30/18) 112 2 9 1 NA 100%


Local PHEP Grant (BP1: ’17-’18) - # of deliverables completed (grant ends 6/30/18) 117 1 14 2 NA 100%

Public Health Emergency Preparedness Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs Narrative

The Emergency Preparedness Program achieved/exceeded on 11 of 11 performance metrics in 2018. Staff have been working on grant deliverables from the current Public Health Emergency Preparedness (PHEP) and City Readiness Initiative (CRI) grants. We received final comments and approval from Ohio Department of Health (ODH) to implement our agency's revised Mass Fatality Response Annex (MFRA). The MFRA will be reviewed with senior management and promulgated in early 2019. We are awaiting final comments from ODH on the agency's revised Emergency Response Plan (ERP). Once final comments and approval is received from ODH, the ERP will be reviewed and implemented. Our Emergency Preparedness Specialist continued providing Points of Dispensing (POD) Orientation training and technical support for POD set-up drills at our long-term care facilities. We participated in a multi-day functional regional exercise involving a large hepatitis A outbreak in southwest Ohio. The after-action report/improvement plan will be drafted in early 2019. We are continuing to build and maintain our Medical Reserve Corps (MRC) volunteer database and are planning a MRC volunteer event to train volunteers on administration of Narcan on December 11, 2018. Our MRC Leadership Team is chaired by HCPH and meets the first Tuesday of every month. HCPH received 400 doses of flu vaccine from ODH that were distributed to existing POD sites.



Programs

4th Quarter2018



EMERGENCY PREPAREDNESS

Page 5

1

1


Epidemiology staff are participating in a joint project with Health Promotion and Education. No No

20%

1 0 0 0 0 1

11 0 0 0 0 11 of 1 grant metric for the Ohio Institute for Equity in Birth Outcomes (OEI) will be meeting or exceeding targets in Hamilton Co.

1 of 1 grant metric for the Ohio Institute for Equity in Birth Outcomes (OEI) will be meeting or exceeding targets in Butler Co.

Maternal & Child Health Requirement

Communicable Disease Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

% Complete YTD StatusQuarter 2 Quarter 3 Quarter 4

Complete monthly contract reports and attend quarterly lab network and infection prevention meetings

Child Fatality Review & Fetal and Infant Mortality Review

Complete daily and monthly overdose reports for Hamilton County 1377 94 94 94 95 100%

50 14 14 11 11 100%


Complete weekly and monthly communicable disease surveillance reports 164 16 16 16 16 100%

Complete cancer report for Hamilton County (Goal) 11 0 0 10% 90% 100%


Complete injury surveillance activities (annual injury data collection and AHEAD tool updates) 2100% 25% 25% 25% 0% 75%

Surveillance Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs Narrative

The Epidemiology Division finished 2018 by exceeding or performing as needed on 8 of 9 metrics. Staff continue to ensure daily overdose reports are published seven days a week. An online version of the daily overdose report is being reviewed and finalized for transition to a web-based platform. A member of the Epidemiology division resigned in October, thus a shift in activities was implemented to ensure time sensitive reports were completed. This has resulted in one of the Division's projects to be marked as 'Behind'. The Division is current on publishing all weekly and monthly infectious disease reports for Hamilton County and contracting jurisdictions. Division staff worked with ODH, NKY, KDH, and CDC on an HIV injection drug use cluster investigation during an Epi-Aid visit. Starting in September, Butler County no longer contracts with HCPH for OEI epi services as the Butler Co Health Department decided to build its own epi capacity.

The Division is also achieving its metrics for the Maternal and Child Health grant for the Ohio Equity Institute project. Several Division staff attended the Infant Mortality Summit (a state conference for state and local MCH professionals). Due to additional projects (i.e. WeTHRIVE! CHAs, Cradle Cincinnati, and OD reports), the Child Fatality Review report has been delayed to accommodate for these time-sensitive projects. The anticipated date for a rough draft is by mid-January. The Fetal Infant Mortality Review report is requiring a longer data validation process due to the presence of data entry errors from when the program was housed at a different agency. This work is being conducted by a public health intern who is currently transferring old electronic data sheets into paper copies and Qualtrics. The division has begun collecting injury data from the hospital systems again in 2018. In Q4, 3 of the 5 major hospital systems' data have been collected. The final systems will be transferring their data by January, 2019.

An MPH student from UC completed an internship by assisting with the injury data collection and analysis. A second MPH student completed a capstone project by analyzing cancer data for an agency report. The Division is continuing its effort with the Live Stories platform to create a new Community AHEAD tool, updating from the current format on our website. Several Epi staff are also working with the HPE division to create a Health Equity report in 2019.



Programs

4th Quarter2018



EPIDEMIOLOGY

Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD Status

Complete Child Fatality Review annual report (Goal) 21 0 0 35% 30% 65%Complete Fetal and Infant Mortality Review annual report (Goal) 31 0 0 20% 0%

Page 6

% Complete YTD

1

HIV Testing

Hepatitis C Testing 2

Pregnancy Tests Provided

63 80 107%HCV+ 276 19 39 41 40 183%

244 61 57

HIV+1 0 0

11,004 251 417 452 397 151%Syringes exchanged 2381,844 95,461 89,186 89,913 62,440 88%

Number of new clients (would be included above, as well)

There have been no current or planned quality improvement projects identified. No No


8 of 8 grant metrics are meeting or exceeding targets (Grant ends 8/31/2018) 18 8 8 8 NA 100%

Quarter 3 Quarter 4 % Complete YTD StatusPrescription Drug Overdose Grant Requirement Quarter 1 Quarter 2

12,500 5,378 6,871 7,105 7,004 211%

0 25%Treatment Referral 2144 36 4 7 2 34%

2296 74 68 90 119 119%

Narcan (doses Distributed) 18,256 2,064 2,560 2,472 1,276 101%

Medical Referral 14 1 10 5 0

24


Number of clients served 28,128 2,032 2,749 2,999 2,682 129%

The Exchange Project Estimate Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs Narrative

The Exchange Project (TEP) completed 2018 with all 11 metrics rated as on track or achieving. Every week there are new clients using the exchange services at all of the service locations. The Narcan Distribution Collaborative (NDC) is on track or performing as needed for 2 of 2 performance metrics, and distributed over 26,000 doses in 2018. The NDC continues to reach out to additional partners around the county to expand dispensing of Narcan in new communities, and is working with healthcare and other organizations throughout the County to create sustainability plans for when NDC doses have all been distributed. Implementation of dispensing in hospital emergency departments is progressing, with an additional two hospital systems distributing Narcan during Q3 and Q4. The Prescription Drug Overdose (PDO) grant continues to meet 8 of 8 grant metrics, and PDO staff are engaged in community education and medical policy change.

Programs



HARM REDUCTION 4th Quarter

2018



400%

Individuals provided Narcan use education 110,005 3,572 3,415 6,021 6,010 190%

2263740 185 216 190 115%

Status

Narcan doses distributed (includes Exchange Project)Narcan Distribution Collaborative Goal Quarter 1 Quarter 2 Quarter 3 Quarter 4

Page 7

1

0

1

23 24 24

Cessation: 4 of 4 grant metrics are meeting or exceeding targets (grant begins 7/1/2018) 24 NA NA 4 4 100%Prevention 4 of 4 grant metrics are meeting or exceeding targets (grant begins 7/1/2018) 24 NA NA 4 4 100%


15 of 15 grant metrics are meeting or exceeding targets (grant started on 9/30/2019) 215

The Division continued its quality improvement (QI) project aimed at standardizing the WeTHRIVE! Process (from recruitment to recognition) in an effort to simplify data collection, improve communication between communities and HCPH, and to allow replication of the WeTHRIVE! process across sectors. During Q4, the team continued planning and testing the pilot. This project will extend into 2019. In addition to the formal QI project, staff is working on mini process improvements that impact their day-to-day work. Documentation of the mini-PDSA's will be submitted at the end of Q4 and are included as part of HPE staff SuccessFactor goals.

In Progress No

Complete Community Health Assessments in partnership with Division of Epidemiology


Yes

HCPH should consider building in linkages from Community Health Improvement Plan to Strategic Plan Yes

Maintain engagement of existing WeTHRIVE! Communities

StatusAccreditation Standard 5.3.2A (Alignment of CHIP)

Yes

NA NA NA 15 100%

WeTHRIVE! Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

122 22 100%

Yes

Yes Review evaluation framework with key stakeholders

Develop framework to evaluate the WeTHRIVE! Initiative. Yes Research community-based evaluation frameworks and models Develop draft evaluation framework Yes

Status

WeTHRIVE! 22 communities committed to the initiative by December, 2018


3 of 3 grant metrics are meeting or exceeding targets (grant ends 9/30/2019) 23 3 3 3 3 100%

Quarter 2 Quarter 3 Quarter 4Maternal & Child Health Requirement Quarter 1

NA NA 100%


Youth: 7 of 7 grant metrics are meeting or exceeding targets (grant ends 6/31/2018) 17 7 7 NA 100%

Tobacco Grant Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

NAPolicy: 7 of 7 grant metrics are meeting or exceeding targets (grant ends 6/31/2018) 17 7 7

4th Quarter2018



HEALTH PROMOTION AND EDUCATION

Programs Narrative

Health Promotion and Education completed 2018 with all measures on track or exceeding. Highlights included the following: Princeton City Schools adopted a 100% tobacco-free campus policy; a Community Health Assessment was presented in Deer Park; two Neighborhood Navigators were hired for the Ohio Equity Institute (OEI) grant (one additional will be hired); HPE was awarded the Maternal & Child Health (MCH) grant from ODH; and the 4th annual WeTHRIVE! Recognition Event honored 19 communities, five school districts, 18 child care providers, and 25 champions. Detailed grant reports are available upon request for the MCH, OEI, and Tobacco grant (monthly). Sydney Battle received the Cradle Cincinnati Community Champion Award for Equity in 2018.

Programs



Page 8

Number of new backflow devices registered1

250 31 86 127 70 126%

Backflow Prevention Goal Quarter 1 Quarter 2 Quarter 3 Quarter 4

Continuous Quality Improvement Current ProjectsNew Projects

Identified

The Division of Plumbing was assigned a project based on feedback provided from the Customer Service Workgroup survey. The completed project was designed to improve contractor knowledge that a building permit number at the time of application with HCPH will decrease plan / application approval time. The team saw a fifty percent improvement in the number of building permits that were submitted correctly.

Yes No

Number of medical gas inspections completed 2109 21 24 39 32 106%

Number of backflow / cross connections surveys completed 160 28 26 50 21 208%



Number of medical gas blueprint reviews completed2

26 6 6 9 4 96%

Medical Gas Permits 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

Number of commercial plan reviews completed 2680 134 205 138 116 87%

Number of residential plan reviews completed2

3,700 722 1,177 883 828 98%

Number of plumbing inspections completed 16,025 1,818 3,055 2,569 2,295 162%


Number of plumbing permits issued2

4,380 856 1,380 1,021 944 96%

Plumbing Inspections 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs Narrative

The Plumbing Division finished with all metrics on track or exceeding in all 8 of its 2018 PIP work objectives. Staff were busy with increased permits and inspections in residential, commercial and medical gas programs. Mirroring the high permit numbers, staff exceeded the anticipated number of inspections. In addition, medical gas permits continued to remain strong throughout the year, exceeding the benchmarks. The Backflow Program continues to be strong, in large part due to the addition of the Village of Lockland into the program. Staff visited the Village weekly to conduct backflow surveys. These surveys have discovered 314 new testable backflow devices that will be tracked annually to ensure compliance. This work is now complete and staff will be able to inspect other communities.



Programs

4th Quarter2018



PLUMBING

Page 9

25 3 6 8 8 100%Number of newly identified children with blood levels greater than 10 μg/dL 115 2 7 3 3 100%


The Division has completed a mini-CQI project for Certified Mailings intake and processing of Return Receipt cards. After some modifications, the project is currently in act stage.

Yes No

Lead Poisoning and Prevention 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4 Status

Number of newly identified children with blood levels between 5-10 µg/dL 1

Number of public health lead poisoning investigations completed 215 2 5 2 4 87%

Number of solid waste nuisance and open dumping investigations completed (3-Yr Avg) 1120 28 45 47 21 118%

Number of compost facility inspections completed 124 0 5 11 12 117%

Number of scrap tire facility inspections completed 160 4 9 24 40 128%


Number of solid waste facility inspections completed 142 9 9 14 12 105%

Solid Waste Inspections Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4


Number of CD&D facility inspections completed 2158 33 37 39 43 96%

Construction and Demolition Debris Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Number of unlicensed facilities located and enforcement initiated (3-Yr Avg) 23 1 1 0 1 100%


Number of facility inspections (Requirement) 243 10 9 6 15 93%

Body Art Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Programs Narrative

The Division of Waste Management achieved all 10 of 10 of its 2018 performance measures. There are a few inspections remaining that will be completed in the last two weeks of the year. All contract obligations have been met for the year. Scrap tire inspections were stalled this summer due to a staffing change in the Environmental Crimes deputy detail. Those inspections have since been caught up and exceeded our target of 60. All 5-10 ug/dL lead cases received in 2018 have been contacted, interviewed, and provided educational outreach. This was accomplished by shifting workload from Disease Prevention. Monthly performance calls with the Ohio Department of Health (ODH) continue to be favorable. One on-site audit occurred in late September, the results of which were favorable. The Ohio EPA annual survey will be skipped this year with continuance on the director's "approved" list of health districts. This is due to our program's good track record and staffing changes at Ohio EPA.



Programs

4th Quarter2018



WASTE MANAGEMENT

Page 10

Number of sanitary sewer connection orders issued58 14 9 7 11 71%

Number of HSTS's Mapped1,203 188 216 205 195 67%

Number of nuisance complaint investigations completed490 80 164 182 100 107%

% Complete YTD

Train Government Employees271 0 143 38 148 121%

Number of Stormwater Pollution Prevention Plan Inspections Completed37 12 11 5 19 127%

Status

Conduct outfall investigations in accordance with the contract and abate pollution5 0 3 2 0 100%

Stormwater 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

6 2 158%

% Complete YTD

116%

3,507 3,463 2,284

Status

New / Replacement PWS Inspections Completed5 1 4 0 3 160%

Private Water Systems 3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4

4th Quarter2018

Number of STS Operation Permit Initial Inspections (Requirement)11,450

3-Year Avg. Quarter 1 Quarter 2 Quarter 3 Quarter 4 % Complete YTD StatusSewage Treatment Systems

Exceeding | Complete: Currently above benchmark or completed.

On Track|Performing as Needed: Progressing as anticipated.

Behind|Unfavorable: Currently behind anticipated progress.

Road Block: Not progressing as anticipated; Re-prioritized.

Programs Narrative

The Division of Water Quality (WQ) has successfully completed 2018 with all 12 metrics on track or achieving. Sewage Treatment System (STS) inspections exceeded the requirements. Follow up inspections were behind the three-year average, due in part to the mailing of pre-inspection postcards. An additional employee for the STS program was included in the 2019 budget to further ensure that all program activities remain on track. Stormwater metrics are on track with STS mapping slightly behind due to the reassignment of one staff member to complete STS inspections and one position temporarily vacant. All WQ metrics are anticipated to be completed or in compliance with contract expectations by year's end. Note: A new metric was added this quarter to show the number of variances that are approved each quarter.

Exceeding | Complete

On Track | Performing as Needed

9

2,738

WATER QUALITY

Programs

New Projects IdentifiedContinuous Quality Improvement

3

0

0 Road Block | Postponed

Number of Requests for Variances (Includes STS & PWS)25 6 4 9 16 140%

Number of Improvement / Modifications Inspections Completed 238 34 79 94 68

105%

PWS Sealing Inspections Conducted12 9 2

NoYes

The Water Quality division completed and presented to the performance management council a CQI project from the technician group based on route optimization. Data collected during analysis projected savings of $25,528 when the CQI was implemented into the Standard Operating Guidelines for 2019. The WQ Division also finished a CQI project evaluating issues with the STS abandonment process to determine more effective steps to increase the number of properly finalized abandonments.

Behind | Unfavorable

2

1

1

1

2

1

1

1

1

1

1

2

Number of STS Operation Permit Follow-up Inspections4,500 609 817 1,149 967 79%

Current Projects

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Provide findings and recommendations based on completed surveys and audits to divisions and to the Performance Management Council

2 1 80%

Requirement

Finalize 2019 survey and audit schedule (To start in 4Q)2

Yes2

Yes

Implement scheduled 2018 surveys (Requirement)2 3

Creation of a community plan to address health equity in community communications and include translation / adaption prioritization

Develop a list of communication methods prioritized by each division Yes

210

Quarter 3 Quarter 4 % Complete YTD Status

Completion of the Health Equity 101 Training by All New Staff 2100% 75 74 74 79 78%

Customer Service Feedback

Creation of the draft 2018-2020 Community Health Improvement Plan that is aligned with the State plan 1

Yes

2018 progress reporting to the Public Health Advisory Council and other key stakeholders

2019 Program Implementation Plan adopted by the HCPH BOH (To start in 4Q)2

In Progress

2018 Quarterly review of HCPH dashboard metrics review completed and continuous quality improvement discussed

Status

Status

1

Quarter 1 Quarter 2 Quarter 3 Quarter 4 Status

Develop recommendations for Communication Plan Approve Communications Plan by communications and administration divisions

% Complete YTD

Health Equity Workgroup Requirement Quarter 1 Quarter 2

Yes1

Yes Develop a budget

Yes

1Yes

Community Health Improvement Plan

Requirement Quarter 1 Quarter 2 Quarter 3 Quarter 4

Assess staff knowledge of core competency

Completed survey on core competencies

Training curriculum updated based on survey findings

Yes

Yes

Programs




Percent of staff who have completed training as required by the workforce development training plan2

94 68 5 5 7 90%

Workforce Development Workgroup

4th Quarter2018



PERFORMANCE MANAGEMENT SYSTEM

1Yes

Status

2018 Program Implementation Plan adopted by the HCPH BOH and dashboard completed1

Yes

Program Implementation Plan

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1

2

2


Private Water Audit (Water Quality)

Programs

Status

Performance Management Action Items 4th Quarter2018




The Division of Plumbing has completed its continuous quality improvement project that was requested by the Performance Management Council based on feedback provided from the Customer Service Workgroup survey. The Division has successfully increased plumbing contractor knowledge that a building permit number at the time of application with HCPH will decrease plan / application approval time. A building permit number is required prior to issuing an approved set of plans.

Status

Customer Feedback Workgroup - Plumbing Customer Survey Status

The Plumbing Division should review the process for informing plumbing contractors of the opportunity to improve permit speed by submitting the building permit number during the HCPH application process.

Yes

Customer Feedback Workgroup - Food Safety Class

1

Notes

Notes

Yes

The private water cost methodology is complete and fees were adopted by the Board of Health on December 10, 2018 with an effective start date of January 1, 2019.

Update private water fees

Notes

Servsafe textbook is currently available to class participants in advance with payment. EH will brainstorm and execute further strategies to get the message out that textbook is available ahead of time.

EH will provide information to customers about obtaining a ServSafe textbook in advance of the class. Website will be updated.

In Progress

Notes

EH will review current educational information for schools and work to develop flyers that follow CDC health literacy guidelines and highlight the most common public health issues that schools face in these categories and how the school should address these issues. There is also the possibility of collaborating with Environmental Health for chemical disposal. The plan is to have these flyers developed ahead of 2019 school inspections.

Customer Feedback Workgroup - School Inspection Program Status

EH will develop flyers on pest management and chemical safety and disposal to be distributed to schools during inspections and linked on website.

In Progress

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Documents

Program Implementation Plan Results: 4th Quarter, …...2019/01/08 · Monitored timely reporting of notifiable/reportable diseases, lab test results, and investigation results (Measure