Strategic Health Plan 2005 Progress Report

Title XX Reduction Plan – The Health District began implementing the Governing Board approved plan to adjust services and resources as a result of the loss of Title XX funding.   Community resources for Title XX eligible women seeking family planning have been identified.  Starting in April, 4C’s family planning services will be offered by appointment on Wednesdays, although we are still permitting follow-up visits scheduled by medical providers on any business day.   Effective April 1^st, there will be a reduction in workforce, impacting non-essential part time positions.   Loss of Title XX funding also impacted the availability of pregnancy test; however, a solution was found in partnership with Mainland Children’s Partnership (see below).

Free Pregnancy Tests - Through a partnership with Mainland Children’s Partnership (MCP), free pregnancy test are still available to women at the MCP office co-located with the Texas City Clinic site.  MCP case managers were trained by the 4 C's Lab Director and the 4 C's Nursing Director to perform the test and to determine the estimated date of delivery, under standing delegation orders.   MCP case managers also assist the women to obtain registration and prenatal appointments at the 4C’s clinic if desired.  In the first three weeks of the project, 59 tests were performed with 40 positive results.  22 women chose the 4 C's for prenatal care and have appointments.   

2005 Sharing the Care Summary Utilization Reports – In 2005, the program helped 4C’s patients receive access to Pfizer medications they needed.  Over 6000 patients filled over 23,000 Rx from Share the Care program, a net worth of 1.5 million dollars.  Most common drugs included Accupril, Lipitor, and Zyretec.

Evaluation of Evening Clinics – Utilization of evening hours in the 4C’s clinics will be evaluated over the next several weeks by clinic managers.  Once completed any changes that may be recommended will be presented to the Governing Board for possible adoption.

Dickinson Bayou Watershed Management Plan - The Health District has been invited and participated in the inaugural meeting of the Dickinson Bayou Watershed Management committee charged with drafting a management plan designed to improve water quality in Dickinson Bayou. The committee is composed of local elected officials, county and state environmental experts and members of the Galveston Bay Estuary Program.  The committee is currently gathering water quality data and has identified silting at the mouth of Dickinson Bayou as one of the major concerns.  This silting limits the amount of water exchange and has created low dissolved oxygen levels and other water pollution issues that hamper aquatic life sustainability.  

High Island Sewage Problem – The Health District participated in a meeting with county elected officials and officials of High Island ISD and Bolivar Special Utility District to discuss the next steps necessary to disconnect homes currently on a non-compliant sewage collection system. The District has issued letters to the residents of the suspected homes requesting additional information on the type of wastewater treatment system currently in use.  The District is also planning to conduct a door-to-door investigation to positively identify the homes connected to this system.  In addition, meetings will be conducted between the County, High Island ISD and the Bolivar Special Utility District to discuss the possibility of another entity maintaining and operating the school district’s permitted wastewater treatment system.  The school district in accordance with state law cannot allow the residents identified in our door-to-door survey to connect to this permitted system unless a third party takes over the operation. If this should occur, the residents currently connected to the non-compliant system will be allowed to connect.   

Valero Chemical Spill - On Monday, February 13, 2006, a Valero tank farm leaked approximately 200 gallons of ethyl acrylate, a colorless liquid with a sharp odor, from a storage tank onto the ground at their facility located on Dock Road in the Port of Texas City complex.  Shortly after the leak, the Health District started to receive inquiries from other local petrochemical facilities and from the general public. The ensuing odor investigation determined that the odor emanating at Valero LP traveled a long distance over several blocks of the east end of Texas City and persisted at a level classified as a nuisance odor.  District investigator’s contacted the facility and reported the situation to management and also to the City of Texas City Emergency Management officials.  The company admitted to the release and began a cleanup operation of the contaminated soils early that morning.  Odors persisted into Tuesday and a follow-up investigation determined that some of the material leaked into the process drains.  The company dispatched a clean up crew to rinse and dispose of the acrylate in the process drains.  At that time, the odors began to subside. The District will be attending a meeting on Friday, February 24^th at Valero LP offices along with officials from the City of Texas City to discuss the incident and ways to improve the company’s communication of future incidents.  The Health District is considering filing a Notice of Violation in accordance with state air control rules.

Program Summaries – community health programs developed one-page summaries with a consistent format, covering program description, services, eligibility requirements, costs, and community partners.  The one-pagers will be used to educate the public and will be place on the community health services web page located at: http://www.gchd.org/chn/INDEX.htm .  The summaries will also be used for integrating outreach activities so that one program can educate the public about other programs (e.g., provide WIC information to public during immunization events, etc).   The summaries will also help educate 4C’s staff about public health program requirements to improve communications and collaboration.

Recruitment - To date, Human Resources have received 37 applications and resumes for the 22 open full time EMS positions and 1 part time EMS position.  12 interviews have been scheduled.  Recruiting efforts include posting the position on various Internet sites and attending various job fairs.

Disease Reporting – Epidemiology staff presented disease-reporting information to 8 participants of the Core Immunization class and 36 Clear Creek ISD nurses.   Information shared included notifiable conditions, how to report, and the 24/7 Epi contact protocol.

Galveston County Teen Parenting Coalition’s Open House - Epidemiology staff presented statistics on teen pregnancy at the Galveston County Teen Parenting Coalition's Open House.  Galveston County statistics for teen pregnancy in 2003 had 30.1 births per 1000 young women between the ages of 15-17 which is substantially higher than the State of Texas and the US, (21.7 and 22.4 respectively).   The Healthy People 2010 goal is less than 43 pregnancies per 1000 young women.   Approximately 25 people were in attendance, representing several school districts, health providers, and community based organizations.

Pandemic Influenza Tabletop Exercise - On January 18, 2006, the Health District, participated in a CDC Pandemic Influenza tabletop exercise held at George Bush Intercontinental Airport.  The following entities sent representatives to participate in this exercise:  Local/State Health Departments (City of Houston, Harris County, Regional and Central State Office); Customs Border Protection and Control, Local Hospitals (St. Luke’s, East Houston Regional Medical Center); Airport Representatives, Law Enforcement, Fire Department, FEMA, CDC, Emergency Management and Red Cross.

Animal Control Officer Training - 19 Animal Control Officers attended euthanasia training - state mandated requirements for certification in animal euthanasia in Texas. 

Cultural Competence Project – As a result of a meeting with Texas Medical Foundation (TMF)’s Health Quality Institute, a class has been scheduled for 4C’s staff at their regular in-service day in April. The class may be videotaped for other health district staff.

Special Needs Satellite Broadcast – a satellite broadcast on “Planning for the Needs of Special Populations” in disasters was presented to staff and representatives of Galveston County Emergency Management and Mainland Medical Center, outlining approaches for serving special needs populations.

Influenza Update - There have been 26 Influenza A cases reported to the Health District in Galveston County.  Flu activity level for Texas is widespread and appears to be decreasing across the state. 

Medical Reserve Corps Orientation - The first and second orientation meetings were held.  Attendees were educated on the history and role of the Medical Reserve Corps in emergencies and discussed the organizational structure and future plans for training and recruitment of members.

FEMA Reimbursement – Staff continue to work with FEMA representatives and we anticipate some reimbursement.  Letters were also sent to Federal and State representatives to request support for other reimbursement sources from the State.

Mental Health Response – Members representing the Gulf Coast Center, UTMB, Red Cross, Devereux Treatment Center, and The Family Service Center, are discussing how to coordinate mental health services in a disaster.  The group decided to host a conference in the spring or summer to bring together mental health and faith based counselors to learn about and discuss disaster response. A date has not yet been set for the conference.

Volunteer Program – 40 volunteers were recruited for the months of January and February and the volunteer coordinator attended several community forums recruiting volunteers and educating the public about health issues.  United Way funding for the program will soon expire.  The District is hopeful for continued funding by Mainland Communities United Way.  Their next board meeting is in early March.

Contracts executed include:

TB Prevention Control in the amount of $47,072 to conduct basic TB services of prevention and control, expanded outreach to identified persons who have or are at high risk for TB

HIV Prevention in the amount of $218,017 to ensure HIV prevention services are provided to persons at the greatest risk as identified through HIV community planning.

STD/HIV in the amount of $121,448 for programs to control and prevent the spread of sexually transmitted diseases including HIV/AIDS and Viral Hepatitis.

HIV HOPWA in the amount of $74,937 which is a reduction from the previous year due to the change in the service area.  The HOPWA program meets the needs of 18 persons living in Matagorda County who have AIDS and related diseases.

GAAA grant from DSHS in the amount of $13,000 with a local match of $18,600 for non-disposable supplies less then $5000 as listed in the grant.

Texas Beach Watch extends the contract to November 2006 and increases the original contract by $70,000 to increase Beach Water sampling to 7,000 samples annually.