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April 2016 (1st Qtr.)Quarterly Report to the Crawford District Advisory CouncilNALOXONE DISTRIBUTED TOBUCYRUS POLICE DEPT.The Ohio Mental Health &ZIKA VIRUSAlthough not a newvirus, 2015 markedthe first widespreadAddiction Services (OhioMHAS)transmission of theprovided funds to every countyZika virus in thehealth department to distributeAmericas. For the firstnaloxone and Project DAWN kitstime, the virus seems(Death Avoidance With Naloxone)to be connected toto local law enforcement,a steep increase in birth defects, includingemergency personnel, and firstmicrocephaly (abnormal smallness of the head).responders. Crawford CountyCoinciding with the Zika virus has been a rise in thePublic Health was allocated 1,800number of cases of Guillain-Barré syndrone (a disorderto fill requests from those agencies.in which the body’s immune system attacks part of theThe funding is available throughperipheral nervous system). The most commonJune 30, 2016.symptoms of Zika virus are fever, rash, joint pain, andIn March 2015, Bucyrus Policeenough to go to the hospital, and they very rarely dieDepartment requested 6 Projectof Zika. Zika virus is spread to people primarily throughDAWN kits & 14 refills. There are stillthe bite of an infected Aedes aegypti mosquito foundsupplies left if any other firstin the tropics and in the southern United States.responders would like to carryHowever, it has also been reported in non-travelersNaloxone as they respond to callsafter their sexual partners returned from an affectedregarding drug overdose.area and developed symptoms. In Ohio, we do notconjunctivitis (red eyes). People usually don’t get sickhave the Aedes aegypti mosquito, but we do have arelated mosquito, the Asian tiger mosquito (Aedesalbopictus) that may potentially transmit Zika virus.The best way to avoid Zika virus infection and othermosquito-borne diseases is to prevent mosquito bites: When outdoors, wear Environmental ProtectionAgency (EPA) registered insect repellents. All EPAAPRIL 2016 DAC QUARTERLY REPORTPAGE 1 OF 12

registered insect repellents have been evaluated for effectiveness. Always follow the productlabel instructions. Unlike many mosquitoes, the Asian tiger mosquitoes are most active during the day and aremost common in shade conditions. Be sure to use insect repellent and wear long sleeves andpants where these mosquitoes are active. Make sure you have good screens on your windows and doors to keep mosquitoes out. Yellow fever mosquitoes and Asian tiger mosquitoes are both container breedingmosquitoes. They do not breed in ponds, puddles or marshes. Remove their breeding sites byemptying standing water from flower pots, buckets and barrels. Change the water in petdishes, and replace the water in bird baths weekly. Drill holes in tire swings so water drainsout. Keep children's wading pools empty and on their sides when they aren't being used.FOOD SAFETY AWARD WINNERSThe food licensing year runs from March 1 – February 28. The 2015 licensing year ended this quarterand we are pleased to see seventeen (17) facilities qualify for a food safety award. This yearswinners are: Buckeye Central Schools, Bucyrus Elementary & High Schools, Crestline Child Care,Crestline High School, The Daily Scoop (Bucyrus), Heartland Care Center (Bucyrus), Katering KountryStyle (Bucyrus), Kentucky Fried Chicken (Galion/Polk Township), Little Athens (Bucyrus), MaplecrestAssisted Living (Bucyrus), Taco Bell (Bucyrus), Walmart, Wynford Elementary and High Schools andWagon Wheel Campground (Shelby/Auburn Township).The criteria to receive a food safety award includes: 0 critical violations for the entire licensing year, 3or fewer non-critical violations, submission of proof of Food Safety Training and submission of a sickpolicy to ensure employees that are ill are not preparing food.ENVIRONMENTAL DIVISION 1ST QUARTER NUMBERS:Food Licenses Issued (Risk Levels 1-4)137Food Inspections51Mobile Food Licenses Issued14Food Re-Inspections0Vending Food Licenses Issued26Water Hauler Inspections2Household Sewage Treatment System Permits 2Septic System Inspections2Private Water System Permits3Solid Waste Inspections4Water Samples Submitted for Analysis21Rabies (Bites/Exposures) Reported19ENVIRONMENTAL HEALTH DIVISIONWe continue to complete the final requirements for the procurement of the Ohio EPA grant moniesto repair and/or replace failing household sewage treatment systems in Oceola (Tod Township). Weare still projected to receive 132,000 for the Oceola project and all contracts should be in placesoon.In March we attended a regional meeting concerning the updates that have been made to theOhio Dept. of Health Campground Rules and Regulations. Several significant changes have beenmade and will be enforced by our department.APRIL 2016 DAC QUARTERLY REPORTPAGE 2 OF 12

ACCREDITATIONThe Community Health AssessmentReport will be presented to thepublic on May 16, 2016 from10:00am – 12:00pm (noon) at GracePoint Church, 683 Portland Way North, Galion, OH 44833. This presentation will be based on the datacollected from Crawford County youth and adults. The local data about Crawford County residentsis reported along with health information from national, state and local data sources. The healthstatus assessment is invaluable because it serves as a guide for strategic planning and decisionmaking. It can help our community identify new health concerns, measure the impact of currentcommunity efforts, and guide the use of local resources. The presentation is open to the public andwe encourage all residents of Crawford County to attend.EPIDEMIOLOGY TRACKING & SURVEILLANCEConfirmed, probable and suspected reportable Infectious Diseases from January 1 through March31, 2016 within our jurisdiction:REPORTABLE CONDITIONChlamydiaHepatitis CGonorrheaLyme DiseaseInfluenza Associated HospitalizationMycobacterial Disease (Not TB)SalmonellaLegionnaires’ DiseaseCryptosporidiosisCampylobacteriosisAPRIL 2016 DAC QUARTERLY REPORT# OF CASES181033211111PAGE 3 OF 12

HELP ME GROW DIVISION (STATE FY 2016 FUNDING - JULY 1, 2015 TO JUNE 30, 2016)HELP ME GROW HIGHLIGHTS This quarter in Help Me Grow we continued our outreach efforts by distributing OH BABY! Kits toarea OB/GYN’s and birthing hospitals. The kits are provided by the Ohio Department of Healthand includes information on nutrition, breastfeeding, safe sleep, becoming new parents, andhas a Fever Scan strip, Read to Your Bunny book, growth chart and emergency numbermagnet. Despite ever tightening restrictions on who is eligible for our programs, we continue to meetstate targets. Nonetheless, we still struggle at times with maintaining some families in ourprograms due to parental drug involvement. We have outreached to local resources such asADAMH Board and Maryhaven to educate ourselves about addiction and the recoveryprocess to better serve these families. Our staff is currently being trained in the “Happiest Baby” Education Program. It is a childabuse and prevention program designed to teach families how to better cope with theirnewborn through age 5 sleep challenges. In February, our Early Intervention Program formally transitioned from Ohio Department ofHealth to Ohio Department of Developmental Disabilities. With the change, many ODH staffwent to DODD. Our services at the local level will remain the same through at least July 1,2017. Our Healthy Families Program is busy preparing for accreditation and a site visit planned formid- August. Danelle Barney, our county’s Healthy Families Grant Manager, is busy writingcounty specific policies for the 12 Healthy Families America Benchmarks relating to maternaland child health. This quarter in HMG we made 470 home visits serving a total of 165 children in our threeprograms: Home Visiting (Parent Education for first time parents); Healthy Families (ParentEducation for second time parents and beyond); and Early Intervention (family centeredservices for children with a developmental delay or medical condition likely to result in adelay). Help Me Grow Staff (comprised of 7 individuals) made a total of 511 home visits.APRIL 2016 DAC QUARTERLY REPORTPAGE 4 OF 12

VITAL STATISTICSFrom January 1 – March 31, 2016 our office has reported the following:JanuaryFebruaryMarchTotalDeaths within our Jurisdiction34202983Burial Permits Issued33232985Births within our Jurisdiction0000Death Certificates requested1067398277Birth Certificates requested6612297285SUICIDE, 2PENDING, 3OTHER,4DEMENTIA, 1HEART DISEASE- MALES, 11SEPSIS, 1RESPIRATORYFAILURE, 14HEART DISEASE- FEMALES, 13RENAL FAILURE,2CANCER, 18PULMONARYEMBOLISM, 1PNEUMONIA, 4CVA/STROKE, 6COPD, 1ALZHEIMER'S, 22016 Causes of DeathTypes of Cancer Deaths (2016)76543210APRIL 2016 DAC QUARTERLY REPORTPAGE 5 OF 12

NURSING DIVISION - 1ST QUARTER HIGHLIGHTSImmunization Program A total of 247 clients were seen and 568vaccines were given this quarterSchool Nursing Children with Medical Handicaps We currently have a total of 104 childrenwe assist with this program 3,370 billed and have received 2,140Communicable Disease The Nursing Department investigated 77communicable diseases the first quarterof the year: 36 Hepatitis C, 3 Hepatitis B,23 Chlamydia and 15 miscellaneousdiseases.Nurses go to Maryhaven every 6 weeksfor communicable disease educationand testingLead Program 6 Lead Screenings performed4 clients receiving Lead CaseManagementSTD/HIV Program There were 19 clients tested for HIV &21clients tested forChlamydia/Gonorrhea at the HealthDepartment. Of the clients tested forSTD’s, 3 received antibiotic treatment.APRIL 2016 DAC QUARTERLY REPORTWe provided 1,359 nursing hours in theschools and billed 44,877.00We provide services for five of ourcounty’s school districts: BuckeyeCentral, Bucyrus, Colonel Crawford,Crestline & Wynford. (We also fill in forthe nurse at Fairway/Waycraft, asneeded.)Jail Nursing Nurses worked 407 hours at the CrawfordCounty Jail and billed 14,366.25Statistics: 331 inmates booked in, 210physicals completed, 339 sick inmatesseen, and 50 treated for drug and/oralcohol withdrawalCouncil on Aging 76 clients seenNurse worked 71 hours and billed 2,586.64Miscellaneous Child Passenger Safety EducationalClassesBlood Pressure ChecksTB Skin TestsVisual Exams for foster child placementChild Fatality Review meetingHead ChecksPAGE 6 OF 12

WIC DIVISION FOR JANUARY – MARCH 2016 (FEDERAL FY 2016 – OCTOBER-SEPTEMBER) Show Rates for January, February and ow RateWalk –insservedTotal #ServedShow RateincludingWalk- ins100%80%84%86%78%80%291443204553757ShowRateWalk –insservedTotal how ion Ed. Show RateMid-certappointmenttypeHigh RiskGroup,ModuleTotalScheduledVendor Coupon Redemption: We have 5 stores in Crawford County that are registered Vendors withthe State WIC Program.Redeem MonthJanuaryFebruaryMarchVendor TotalTransactions2615223523297179Amount Redeemed 62,303.59 54,478.45 57,130.77 173,912.81Amount Paid 60,448.03 53,464.73 56,461.18 170,373.94Below is a summary of the Crawford County residents served this quarter.JanuaryFebruaryMarchTotal 1stquarterPregnantWomen106101105312Case LoadFY 16 - mberJanuaryFebruaryMarch1200APRIL 2016 DAC QUARTERLY 250130013521357135413501400144014501500PAGE 7 OF 12