2014 SALT LAKE COUNTY

HEALTH DEPARTMENT

ANNUAL REPORT

Salt Lake County Health Department2 |

ABOUT SLCoHDAs a division of the Salt Lake County Human Services Department, the Salt Lake

County Health Department (SLCoHD) works to protect and improve the well-

being of all county residents by preventing disease, illness, and injury and by

impacting social, economic, and environmental factors fundamental to excellent

health. While some county divisions provide services only to residents living

within unincorporated areas, the SLCoHD is charged with the responsibility of

providing public health services to residents in

both incorporated and unincorporated areas.

The structure of governmental public health

agencies at the state and local levels varies

considerably across the country. Utah has

established a decentralized organizational model

for public health in which local public health

agencies are organizationally independent of

the Utah Department of Health and are primarily

governed by local boards of health. The Utah

Legislature established these “local health

departments” under Title 26A of the Utah Code.

State law requires local health departments to

have a policy-making Board of Health (BOH); the SLCoHD has a 15-member

board appointed by the Salt Lake County Mayor, and county ordinance outlines

the qualifications for board members. The BOH is responsible for setting public

health policy for the department and may adopt and enforce public health

rules, regulations, and standards necessary to implement the public health

policies. Standards and regulations adopted by the BOH supersede existing local

standards, regulations, and ordinances.

The Board also approves the budget, which the health department submits to

Salt Lake County. The county is responsible for setting administrative (personnel

and fiscal) policies for SLCoHD. Our budget is comprised of federal and state

funds, county general funds, and fees collected for department services.

Approximately one-third of the budget comes from each of those sources.

2014 Annual Report | 3

FROM THE DIRECTORThis year has been a remarkable one for the Salt Lake

County Health Department. In December 2014, after years of

preparation, the Public Health Accreditation Board (PHAB)

recognized SLCoHD as a nationally accredited public health

department.

The journey to accreditation started in March 2011, when

the department began its Community Health Assessment

and, in 2013, its Community Health Improvement Plan.

After countless staff hours, the department submitted its

accreditation application in July 2013 and then spent the next year gathering

supporting documentation and preparing for a site visit from PHAB.

PHAB’s team visited SLCoHD in September 2014; their resulting report

highlighted the department as a highly functioning and successful local

health department. Site visitors noted that the department is innovative, and

extremely responsive and transparent in its work with the county, its board of

health, and the public; they also characterized the department as very visible

in the community and department staff as “very skilled” at identifying health

problems in the community, prioritizing issues, and identifying solutions and

strategies to improve community health status.

As director, I am extremely proud of the superb work department staff has

done, both in pursuit of national accreditation, and in serving the public health

needs of all Salt Lake County residents. As we look to the future, we will use

what we’ve learned through the accreditation process to continue improving

the many SLCoHD programs that help keep our residents happy and healthy.

Thank you for your interest in this 2014 annual report of the Salt Lake County

Health Department.

Gary Edwards

IN 2014:

5,152ROUTINE RESTAURANT

INSPECTIONS

45,000REPORTS OF DISEASE

62,040VACCINES GIVEN

1,978,454POUNDS OF HAZARDOUS

WASTE COLLECTED

2014 Annual Report | 5

PROGRAM HIGHLIGHTSSLCOHD INCLUDES DOZENS OF PROGRAMS ACROSS A WIDE RANGE OF

ENVIRONMENTAL AND COMMUNITY HEALTH CONCERNS. THE FOLLOWING ARE

2014 HIGHLIGHTS FROM SOME OF THEM.

AIR QUALITY

The Air Quality Bureau regulates the county’s motor vehicle emissions program,

as well as enforces regulations regarding stationary sources of air pollution. The

emissions program has been in effect in Salt Lake County since 1984, and this

year program staff launched a new vehicle repair assistance program (VRAP) to

provide financial assistance to qualifying, low income vehicle owners whose

vehicle has failed the emissions

inspection and who are financially

unable to obtain competent

emissions system diagnostics and

repair.

The emissions program oversees

436 decentralized stations and

1,984 technicians. SLCoHD

staff estimates that the vehicle

emissions program prevented more

than 11,000 tons of air pollution from being released into the valley this year.

In 2014, the Air Quality Bureau also drafted a new health regulation regarding

solid fuel burning for adoption by the Salt Lake County Board of Health. This

regulation limits solid fuel burning during the months of November through

February to “unrestricted action days” as declared by the Utah Division of

Air Quality.

CHRONIC DISEASE PREVENTION

SLCoHD’s Chronic Disease Prevention program works to reduce the incidence

of chronic diseases —such as heart disease, stroke, diabetes, and cancer—by

addressing preventable risk factors such as smoking, physical activity, nutrition,

and obesity.

Subprograms within the Chronic Disease Program include physical activity and

nutrition programs such as Be Active and Healthy.Chronic Disease Prevention

also administers Salt Lake County’s employee wellness program, Healthy

Lifestyles. In place since 1989, Healthy Lifestyles served 1,838 county workers in

2014, including 343 new participants this year.

Salt Lake County Health Department6 |

EMERGENCY RESPONSE

The Emergency Response program is a group of Environmental Health

employees who are on call 24 hours a day, 365 days a year, and who respond

to public health issue which requires immediate attention. In general, this

includes any discharge of pollutants into the air, soil, or water in the Salt Lake

Valley. Whether the discharge is intentional or accidental, the Salt Lake County

Health Department Emergency Response Team will respond to assess the

situation and work with federal, state and local government officials to abate

the problem and identify the responsible party.

In 2014, there was a total of 442 emergency responses and consultations, an

increase of nearly 16% from the previous year and the highest yearly total

recorded since 2003. The most common reasons for requests were illegal

discharges and hazardous waste spills but also included methamphetamine

contamination and other housing issues as well as suspected bioterrorism

threats and noise complaints.

EPIDEMIOLOGY

The SLCoHD Epidemiology Bureau monitors the health of the community

in Salt Lake County by providing education and information relating to

communicable disease outbreaks. To protect county residents from foodborne

illnesses, emerging infectious diseases, and other communicable diseases, the

bureau investigates reportable diseases, conducts surveillance activities, and

analyzes and interprets data to aid in disease prevention.

During 2014, the Epidemiology and Infectious Disease Bureaus jointly

investigated four multistate outbreaks (two outbreaks were associated with Salt

Lake County restaurants), five statewide outbreaks, and 32 Salt Lake County

gastroenteritis outbreaks. From 2013 to 2014, there was a notable increase

of 30% more cases of salmonellosis, a continued upward trend over the past

several years.

This year, staff members were heavily involved with preparedness and

response planning to ensure early recognition and reporting of suspected

Ebola exposures. The Bureaus monitored 10 travelers to areas of West Africa

with widespread Ebola transmission for the required 21 days and none

developed symptoms. Staff also investigated two Q fever cases and identified

the source of their infection. Q fever is rarely reported with only about 55 cases

reported annually throughout the U.S.; the affected individuals in Salt Lake

County raised goats and were exposed to birthing material during the

birthing process.

2014 Annual Report | 7

FOOD PROTECTION

The Food Protection Bureau permits 4089 food service establishments in Salt

Lake County. In 2014, bureau staff completed 5152 routine inspections, 1514

inspections of temporary food events, 216 residential daycare inspections, and

122 mass gathering inspections.

In addition, Food Protection staff investigated 767 citizen complaints and, with

Epidemiology Bureau staff, completed 42 foodborne illness investigations. The

bureau took corrective action against 32 permanent establishments (0.7% of

permitted facilities) 29 temporary establishments (1.8% of permitted), and 13

food carts, trucks, or trailers (8% of permitted mobile vendors) this year (23% of

mobile vendors were closed in 2013). All permanent and mobile establishments

were inspected in 2014.

HOUSEHOLD HAZARDOUS WASTE (HHW)

HHW runs two full-service, permanent facilities that accept household

hazardous waste from Salt Lake County residents. The program also operates

two ABOP (antifreeze, battery, oil, paint) centers as well as electronic waste,

fluorescent light, and medication

collection sites around the valley.

In 2014, the program kept 1,978,454

pounds of hazardous waste from the

valley’s landfills. Chemicals accounted

for 1,066,209 pounds, including 475,326

pounds of latex paint. The reuse and

recycling program kept 24% of collected

chemicals from disposal, and also netted

the department approximately $27,000.

Electronics continued to be the largest

single waste stream collected with

912,245 pounds (46% of all waste).

Samsung continues to support the

disposal of electronics, paying $160,322

in disposal costs for 2014.

Salt Lake County Health Department8 |

IMMUNIZATIONS

In 2014, Immunization Program continued to provide all required and

recommended vaccines to infants, children, teens, and adults. This year the

program had a goal to increase the percentage of teens by 5% who had received

one Tdap, two varicella, one meningococcal, and three HPV vaccines. The

program met its 5% increase goal for Tdap and the two varicella.

Immunization nurses also asked each parent, and other

adults coming into clinics, if they had received a Tdap and

(during flu season) a flu vaccine in order to increase the

number of adults receiving these two vaccines.

In total, SLCoHD immunization nurses administered a total

of 62,040 vaccines to clients in 2014.

INJURY PREVENTION

The Injury Prevention Program actively promotes child passenger, teen

driver, and senior citizen safety initiatives, as well as the Salt Lake County

branch of the national Safe Kids program. Injury Prevention staff conduct car

seat installation classes, senior fall classes, and teen driver safety outreach

activities, as well as host car seat recycling opportunities countywide.

This year, Injury Prevention provided car seat education classes to 623

residents, and staff individually checked the installation of 603 car seats. The

program also distributed 600 car seats to families in need, and the car seat

recycling effort prevented more than 11,000 pounds of plastic and metal from

county landfills.

PUBLIC HEALTH NURSING

Public Health Nursing (PHN) provides home visitation services to at-risk

families in Salt Lake County. PHN services are provided primarily through the

Targeted Case Management (TCM) and Nurse-Family Partnership

(NFP) programs.

The TCM program provides annual home visits to Medicaid clients from birth

to four years of age. TCM links clients to the community resources they need;

children identified as high risk can be seen up to three times. In 2014, TCM

nurses conducted 4,591 home visits to clients.

2014 Annual Report | 9

The NFP program is an evidence-based nurse home visitation program that

improves the health, well-being, and self-sufficiency of low-income, first-time

parents and their children. Each mother served is partnered with a registered

nurse early in her pregnancy and receives ongoing home visits that continue

through the child’s second birthday. This year, NFP nurses provided 1,724

home visits, seeing an average of 93 clients each month.

STD CLINIC AND PREVENTION PROGRAM

The STD Disease Investigation and Prevention Program provides prevention

education and outreach services to Salt Lake County residents who are

diagnosed or at risk for infection. The program strives to provide effective,

compassionate and nonjudgmental resources to patients and their sexual

partners. In 2014, the program counseled and educated more than 5,200

patients who were diagnosed with an STD.

The STD Clinic offers low-cost STD tests via appointment or walk-in; HIV

testing is available with same-day results. In 2014, the clinic performed 10,173

STD tests on approximately 4,000 patients.

The table below shows the total number of STD cases reported in Salt Lake

County in 2014 (not just those seen in the SLCoHD STD Clinic):

SANITATION AND SAFETY

The Sanitation and Safety Bureau addresses complaints and deficiencies

regarding housing, solid and infectious waste, transient encampments, noise

pollution, indoor air quality, mold, lead, radon, and vermin infestation. The

bureau also regulates cosmetologists, body art facilities, meth-contaminated

properties (below), massage establishments, hotels/motels, and other

permitted businesses.

In 2014, the Bureau conducted 1,798 inspections of permitted facilities in Salt

Lake County and investigated 2,814 housing, solid waste, or facility complaints.

The bureau also closed 336 residential properties to occupancy or entry, 244 of

which were chemically contaminated by methamphetamine.

DISEASE NUMBER OF CASES

Chlamydia 4174

Gonorrhea 969

HIV 78

Syphilis 70

Salt Lake County Health Department10 |

TOBACCO PREVENTION AND CESSATION

The Tobacco Prevention and Cessation program implements evidence-based

strategies to prevent and reduce tobacco use among Salt Lake County residents.

Tobacco program staff conduct undercover compliance checks, facilitate youth

and community anti-tobacco groups, offer tobacco cessation resources, and

investigate secondhand smoke complaints in multiunit residential dwellings.

This year, the program conducted an e-cigarette liquids study by collecting 153

products from 30 randomly selected retail stores, which were then analyzed by

the University of Utah Department of Toxicology to determine if the nicotine

content actually in the product matched the amount listed on the label. The

study found that the nicotine content

varied by as much as 840% from what

was listed; these discrepancies supported

the department’s new regulation of these

products this year.

In 2014, staff also completed 1,448 tobacco

retailer compliance checks and found 134

sales to minors—a 9.3% rate of illegal sales.

In addition, the program trained more than

200 tobacco retailers on tobacco sales laws

and enrolled 54 teens in the End Nicotine

Dependence (END) program.

VITAL RECORDS

SLCoHD maintains four vital records offices within Salt Lake County. The

offices offer birth and death certificates as well as marriage and divorce

abstracts. In 2014, Salt Lake County had 22,068 births and 7,151 deaths (plus 130

fetal deaths). Below shows the number of certificates ordered.

RECORD NUMBER ORDERED

Birth Certificates 23,116

Additional birth copies 4,501

Death Certificates 8,467

Additional death copies 40,802

Marriage/Divorce Abstracts 388

Additional abstract copies 59

2014 Annual Report | 11

WATER QUALITY

The Water Quality Bureau regulates and inspects solid waste and processing

facilities, drinking water systems (including fluoridation levels and processes),

individual waste water systems, and the

1,063 public swimming pools in the county.

Water Quality staff conducted 1,089 routine

pool inspections in 2014, and closed 129

pools (11.8%) due to an imminent health

hazard. The department also increased the

number of registered pool operators in the

county from 46% to 73%, or an additional

282 facilities.

This year, the bureau conducted 23 sanitary

surveys on public drinking water systems and investigated 59 complaints (an

increase of 127% over last year). Staff also processed 512 routine water samples

and 456 fluoride samples.

WIC

Through federal support, the SLCoHD WIC program

provides low-income women, infants, and children up to

the age of 5 with nutrition education, breastfeeding support,

supplemental food, and access to health care.

In 2014, WIC staff served an average of 22,443 clients each

month (5,549 women, 5,268 infants, and 11,628 children),

and SLCo WIC was responsible for $13,720,445.19 in actual

food expenditures.

WOMEN’S CANCER SCREENING/BEWISE

The Women’s Cancer Screening program works to assist women in detecting

breast and cervical cancer at its earliest stages. Traditional services—including

breast exams and pap tests—are available for women aged 40-64. Expanded

services, part of the affiliated “BeWise” program, are available to women aged

50–64, and include cholesterol, blood pressure, and glucose testing, as well as

BMI and personal health coaching.

In 2014, 2,496 Salt Lake County women received breast and cervical cancer

screening services, and 1,171 women participated in BeWise. More than 360

people participated in BeWise health workshops, and BeWise staff held 1,237

face-to-face coaching sessions and 1,294 phone coaching sessions.

Salt Lake County Health Department12 |

FACILITIES

ENVIRONMENTAL HEALTH

788 East Woodoak Lane

Murray

TRAVEL CLINIC

2001 South State Street

Suite S2400

Salt Lake City

ELLIS R. SHIPP

PUBLIC HEALTH CENTER

4535 South 5600 West

West Valley City

ROSE PARK

PUBLIC HEALTH CENTER

799 North Redwood Road Suite A

Salt Lake City

SALT LAKE CITY

PUBLIC HEALTH CENTER

610 South 200 East

Salt Lake City

SOUTHEAST

PUBLIC HEALTH CENTER

9340 South 700 East

Sandy

SOUTH MAIN

PUBLIC HEALTH CENTER

3690 South Main Street

South Salt Lake

WEST JORDAN WIC

1740 West 7800 South

West Jordan

2014 Annual Report | 13

ORGANIZATION

BOARD OF HEALTH

Russ Booth

Councilman Arlyn Bradshaw

Scott Brown, Past Chair

Kelly Christensen, 1st Vice Chair

Clare Coonan

Judy Cullen

Mayor Robert Dahle

Dr. George Delavan, Chair

Joe Garcia

Tom Godfrey

Brooke Hashimoto

Chris Hemmersmeier

Paula Julander

Dr. Harry Rosado

Dr. Jeffrey Ward, 2nd Vice Chair

LORI BAYSDirector,

Human Services

PAM DAVENPORTCommunications

Manager

DOROTHY ADAMSDirector,

Administration

Facilities

Finance

Information Services

Personnel

Emergency Management

Epidermiology and Infectious Disease

International Travel Clinic

STD/HIV Clinic and Prevention

Vital Records

Air Quality

Emergency Response

Food Protection

Household Hazardous Waste

Sanitation and Safety

Water Quality

Immunizations

Public Health Centers

Public Health Nursing

WIC

Chronic Disease Prevention

Healthy Communities

Injury Prevention

Tobacco Prevention and Cessation

Women’s Cancer Screening/BeWise

DR. DAGMAR VITEKDirector,

Medical Division

DR. ROYAL DeLEGGEDirector,

Environmental Health

DR. AUDREY STEVENSON

Director,Family Health

DAN KINNERSLEYDirector,

Community Health

GARY EDWARDSExecutive Director

SALT LAKE COUNTYBOARD OF HEALTH

BEN McADAMSMayor,

Salt Lake County

Salt Lake County Health Department14 |

FINANCES

EXPENDITURES BY DIVISION

Administration $2,784,591 9%

Facilities $2,752,878 8%

Community Health $2,490,206 8%

Environmental Health $7,411,696 23%

Family Health $10,128,195 31%

Medical $6,643,070 21%

Total $32,210,637 100%

Administration

Facilities

Family Health

Medical

Community Health

Environmental Health

BY APPROPRIATION UNIT

Personnel $24,033,196 75%

Operating Expenses $6,026,901 19%

County Overhead $1,838,698 6%

Debt Service $200,640 1%

Capital $43,931 0%

Indigent Burials $67,272 0%

Total $32,210,637 100%

County Overhead

Debt Service

Indigent Burials

Capital

Operating

Personnel

REVENUE BY TYPE

County Tax $12,294,230 37%

Fees/Other $11,406,783 34%

Grants $9,598,349 29%

Interest $61,036 0%

Internal Funds $12,930 0%

Total $33,504,915 100%

County Tax

Grants

Fees/Other

Interest Internal Funds

2014 Annual Report | 15

HISTORY1849 —Brigham Young creates the Society of Health, precursor to the Salt Lake

City Health Department.

1898—Utah Legislature establishes the Utah state Board of Health.

1899—Salt Lake County Commissioners create the County Health Board.

1943—Salt Lake City Planning and Zoning Commissions recommend that the

Salt Lake City and Salt Lake County Health Departments be merged into

one organization as part of the city’s “50-year plan.”

1965—City Health Department opens its new building

at 610 East 200 South.

1966—County Health Department moves into the old

county hospital at 2100 South State Street.

1969—Salt Lake City and Salt Lake County Health

Departments are merged into the Salt Lake

City-County Health Department—26 years after

consolidation was first recommended.

1974—City-County Board of Health adopts a uniform

health code for the county’s 10 municipalities.

1994—Health department adds three immunization

clinics in West Valley, Sandy, and Rose Park.

1995—Ellis Shipp Public Health Center opens in West

Valley City.

1998—Environmental Health Division moves its four bureaus to a new building

in Murray.

2000—Salt Lake City-County Health Department becomes the Salt Lake Valley

Health Department.

2007—South Main Public Health Center opens in South Salt Lake.

2013—Salt Lake Valley Health Department becomes Salt Lake County Health

Department.

2014—Salt Lake County Health Department receives national public health

accreditation.