Strategic Plan for 2017-2018 - Person County, NC

 
Strategic Plan
      for
 2017-2018

    Adopted by the Person County Board of Health - May 22, 2017

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Executive Summary:
Person County Health Department’s management team met on March 27, 2017 for the purpose of strategic
planning. During this meeting, the group assessed the status of the 2016-2017 Strategic Plan objectives;
identified objectives to continue working towards over the next year; reviewed and analyzed data from the 2014
Community Health Assessment (CHA) and community health survey as well as the 2016 State of the County
Health (SOTCH) report and other influencing data; prioritized objectives; and identified department strengths
and weaknesses applicable to meeting the objectives for the new fiscal year. The status of the 2016-2017
objectives and outcomes/explanations are detailed in Appendix A.

Members of the Board of Health received a draft of the proposed 2017-2018 Strategic Plan by mail or email for
review prior to their meeting on May 22, 2017. After discussion at the meeting, the Strategic Plan for 2017-
2018 was adopted. The final plan is available to staff via the share drive. The Board of Health, community
partners, and the public have access to the plan through the department’s website.

Person County Health Department’s Strategic Plan:
       √ Includes a review and analysis of factors influencing the health department’s ability to improve the
         community’s health.
       √ Uses local health status data and information to set goals and objectives.
       √ Uses community input where applicable.
       √ States desired outcomes for each element.
       √ Sets priorities.
       √ Uses community collaborations to implement activities.

Tagline: “Promoting, Protecting and Nurturing the Health of Our Community”

Mission
The mission of the Person County Health Department is to promote, educate, and protect personal, family, and
community health; ensure a safe environment; provide and assure access to healthcare throughout life; prevent
and control the incidence and spread of disease; and provide community based education and information to
encourage healthy lifestyle choices.

Vision Statement
The result of the work of the Person County Health Department is a community that is healthy, able to reach its
full potential, and supported throughout life, in a safe and clean environment.

Core Beliefs
What are “Core Beliefs”? “Core Beliefs” capture the beliefs we hold about what matters most.

The Individual
We value all individuals.
We respect all individuals.
We support and foster trust between individuals and groups.
We recognize the need to balance work and family.

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Client and Community
We respect client confidentiality.
We treat all clients with dignity and respect.
We commit to the health and safety of our clients and the community.
We recognize that all persons have the right to health care that promotes dignity and respect.
We do all we can for those we serve.

Achievement through Teamwork
We respect and appreciate differences.
We value open, honest and constructive communication.
We recognize that quality emerges from individuals who share a mission and values.

Integrity
We own up to our mistakes.
We do what we say we will do.
We endeavor to do the best we can.
We will not compromise on what is right.
We take responsibility for our own behavior.

                                             Goals and Objectives

The goals and objectives established for the department’s 2017-2018 Strategic Plan are based on data from the
2014 CHA; a community health survey conducted as part of the CHA process; the 2016 SOTCH report;
internal records/databases and contracts for various programs; and mandates through the North Carolina
General Assembly as well as some funding sources.

Data and information reviewed in the development of this plan from the 2014 CHA:

o Person County’s 10 leading causes of death (2008-2012) according to the 2014 CHA were (1) cancer; (2)
  heart disease; (3) stroke; (4) chronic lower respiratory diseases; (5) all other unintentional injury; (6)
  diabetes; (7) Alzheimer’s disease; (8) pneumonia and influenza; (9) unintentional motor vehicle injury; and
  (10) septicemia.

o Additional data from the most recent CHA on pregnancy rates for teens ages 15-19; infant mortality; adult
  and childhood obesity; and adult diabetes was also taken in account when preparing this strategic plan.

o Other considerations in the development of this plan include the 624 responses received from the
  community through a survey during the CHA process in 2014. (The survey was conducted via random
  sampling and convenience-style.) The community indicated through these surveys that the top 10 “Most
  Important Health Problems” in the county are: (1) cancer; (2) obesity/overweight; (3) heart disease/heart
  attack; (4) substance abuse; (5) diabetes; (6) mental health; (7) teenage pregnancy; (8) Alzheimer’s disease;
  (9) lung disease; and (10) stroke. They also concluded that (1) drug abuse; (2) alcohol abuse; (3) lack of
  exercise; (4) poor eating habits; (5) smoking/tobacco use; (6) lack of parenting skills; (7) lack of preventive
  medical care; (8) having unsafe sex; (9) reckless/drunk driving; and (10) violent/angry behavior were the 10
  “Most Important Unhealthy Behaviors” that needed to be addressed. Respondents revealed that the 10
  “Most Important Community Issues” were (1) under/unemployment; (2) low income/poverty; (3) gang
  activity; (4) affordability of health services; (5) crime; (6) lack of recreational facilities; (7) dropping out of
  school; (8) lack of mental health services; (9) availability of healthy foods; and (10) neglect and abuse.

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o After thoroughly reviewing both the primary and secondary data at length, the CHA Team established the
  following health priorities for 2015-2019: Overweight/Obesity and Diabetes

Note: These are the 2 priorities that were cited in the CHA document for which Action Plans will be developed
and submitted to the state. However, the CHA team also strongly recommended that if opportunities and
resources present themselves to the Health Department, Healthy Personians, and any other community
organization that efforts should be made to also address cancer, heart disease, stroke, physical
activity/nutrition, and substance abuse.

Data and information reviewed in the development of this plan from the 2016 SOTCH report:

o Person County’s 10 leading causes of death (2011-2015) according to the most current data found for this
  report are: (1) cancer; (2) heart disease; (3) stroke; (4) chronic lower respiratory diseases; (5) diabetes; (6)
  all other unintentional injuries; (7) Alzheimer’s disease; (8) pneumonia and influenza; (9) unintentional
  motor vehicle injury; and (10) septicemia. This is no change from the rankings in the 2015 report.

o Person County’s infant mortality rate increased to 8.3 (2011-2015) from 7.2 (2010-2014).

o Person County’s pregnancy rate for females ages 15-19 decreased from 2014 (51.3) to 2015 (43.6).

o From 2015 to 2016, the overall cases of communicable diseases decreased from 391 to 341 cases, which is a
  decrease of 13%. There was a 17% increase in sexually transmitted infections (269 to 316 cases). There
  was a significant decrease (87%) in general communicable diseases from 2015 to 2016. The notable
  difference was due to the occurrence of a norovirus outbreak in 2015.

o The estimated prevalence of adult diabetes had decreased slightly to 10.6% (2013) from 11% (2012).

o The estimated prevalence of adult obesity remained the same (32.5%) in 2012 and 2013.

o Emerging issues in public health in 2016 were centered on the following: substance abuse, sexually
  transmitted infections, hoarding, and transitions in the WIC Program.

Data from the following programs was also reviewed and taken into consideration in the development of this
plan: family planning, immunizations, environmental health, and preparedness.

In conclusion, health issues and associated risk factors will be addressed as the department has the capacity to
do so. The availability of federal, state, and local funds will continue to be an influencing factor in the
department’s ability to improve the community’s health. These funds along with grants and donations obtained
will support existing efforts and make provisions for additional programs and services. Individual agreement
addenda through various department programs will also address some of these goals. Additional influencing
factors recognized by the department that are key to working towards objectives in this plan include staff
retention and training. The department’s Workforce Development and Staff Development Plan detail
department directives in retaining staff and ensuring they are appropriately trained. The objectives in this plan
are department-wide focused. Public health also relies on numerous partners, both traditional and non-
traditional, to help fulfill its mission, goals, and objectives.

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Department Goals

1. Retain employees.

2. Increase the number of unduplicated Family Planning clients.

3. Increase the number of Family Planning clients using Long Acting Reversible Contraception.

4. Increase access to Family Planning services.

5. Increase referral source satisfaction with referral submission.

6. Promote Home Health and Hospice in the community through marketing and outreach efforts.

7. Target community physicians and other medical providers for educational opportunities for hospice
   services.

8. Monitor service requests for new/changed skilled care and adjust staff training and competencies
   accordingly.

9. Establish breastfeeding promotion and support activities within the Health Department and the community.

10. Increase rates of infants in the WIC Program who continue to breastfeed at six weeks of age based on the
    state fiscal year 2017-2018 Agreement Addendum.

11. Participate in the Region V Minority Diabetes Prevention Program Collaborative.

12. Increase the department’s capacity to address pre-diabetes and diabetes prevention.

13. Increase the number of Gardasil vaccines administered by the age of 19.

14. Improve health outcomes, clinic efficiency, and provide cost effective services.

15. Complete time period goals for Operation Rejection improvement plan.

16. Improve responder health and safety and other public health capabilities.

17. Continue partnership with Flu Near You for pandemic prevention.

18. Continue Medical Reserve Corps Staying Alive and Pandemic Free Campaign and revisit Roxboro
    Community School’s participation.

19. Restructure Medical Reserve Corps for volunteer proficiency, collaboration, and continuity.

20. Enroll public health employees into Medical Reserve Corps.

21. Implement competency checks for all nursing skills agency wide.

22. Finalize Safety Program Policies and Procedures.

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23. Complete time period goals for Star Annual Report.

24. Rectify all infection control deficiencies and implement best practices and staff compliance with
    regulation, advocacy, education, and practice.

25. Determine the health status of the county and any emerging issues.

26. Implement the WIC EBT (eWIC) Project under the guidance and consultation provided by the State
    Nutrition Services Branch.

27. Maintain the efficient delivery of high quality Environmental Health services to the citizens of Person
    County in order to promote and protect the environment and public health.

                                      Objectives Matched to Goals
The department’s objectives for FY 2017-2018 were prioritized by the management team and are listed below
in descending order. Initially, objectives were listed on a dry erase board in no particular order. Factors taken
into consideration throughout the team’s discussion about prioritizing the objectives included things such as: the
time and steps each objective will require; the resources and support that would be available and needed; the
urgency of meeting some objectives as opposed to others; the progress that has been made already towards
objectives; the availability of staff and community partners to work towards meeting objectives; etc. Several
objectives were rearranged throughout the process until a consensus was met by the team.

Objective 1: Beginning with the next application process, retain employees for a minimum of five years from
hire date. This will allow the department to meet return on investment (training, etc.) and time to cross-train
employees for the viability of the agency.

Goal(s) Addressed: Retain employees.

Partners Involved:
   o Management team and other supervisors
   o Other designated staff
   o Human Resources (HR) staff

Activities:
   o Arrange and complete training for management team and supervisors with County HR for tips regarding
       recruitment, including tips on what not to do during the recruitment process.
   o Assess the need for basic skills/competency check during the interview process and develop draft/trial
       considerations of high turnover positions.
   o Update employee orientation guide to reflect priority of orientation guide and assure employees
       complete these requirements prior to assuming additional position specific duties or not being put in
       harm’s way as required by OSHA.
   o Ensure all applications prior to hiring manager review have had a candidate qualification review form
       completed by appropriately trained and authorized department representative.
   o Develop policy/procedure to reflect an interdisciplinary interview panel with representation or questions
       from three other program areas the position would work closely in collaboration with for their duties.
   o Update position specific interview questions to reflect best practices and worksite specific challenges.

Desired Outcome: Retain employees for a minimum of five years from their hire date.
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Objective 2: By June 30, 2018, increase by 6% the number of unduplicated Family Planning clients and
increase by 50% the number of Family Planning clients using Long Acting Reversible Contraception (LARC).

Goal(s) Addressed:
  o Increase the number of unduplicated Family Planning clients.
  o Increase the number of Family Planning clients using LARC.
  o Increase access to Family Planning services.

Partners Involved:
   o Clerical staff
   o Clinical staff
   o Foreign Language Interpreter
   o Media
   o Duke providers
   o Private providers

Activities:
   o Increase clinic hours by 1-2 evenings per month.
   o Advertise extended clinic hours and Family Planning services.
   o Educate staff and partners regarding LARC methods of birth control.

Desired Outcomes:
   o At least 6% increase in unduplicated Family Planning clients.
   o At least 50% increase in Family Planning clients using a LARC method.
   o Increase STD services through Family Planning clinics.

Objective 3: By June 30, 2018, Home Health and Hospice will increase overall admissions by 5% for each
program.

Goal(s) Addressed:
   o Increase referral source satisfaction with referral submission.
   o Promote Home Health and Hospice in the community through marketing and outreach efforts.
   o Target community physicians and other medical providers for educational opportunities for hospice services.
   o Monitor service requests for new/changed skilled care and adjust staff training and competencies accordingly.

Partners Involved:
   o Community medical providers
   o Person Memorial Hospital
   o Nursing homes and assisted living facilities
   o Community partners (Person County Senior Center, Department of Social Services)
   o Medical providers in adjacent counties (Duke University Medical Center, University of North Carolina Hospital,
       physicians, etc.)

Activities:
   o Develop and implement a streamlined and user-friendly referral process.
   o Monitor referral patterns and target low referral areas for outreach.
   o Participate in community events and perform outreach at community gatherings (Personality, church speaking
        engagements, etc.).
   o Advertise in local media outlets.
   o Identify community learning needs and provide educational opportunities (Advanced Directives, DNR – Do Not
        Resuscitate, etc.).
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o   Educate and in-service staff to ensure competency on new services/procedures for skilled care.

Desired Outcome(s):
   o Increased promotion of Home Health and Hospice services in the community.
   o The agency will have appropriately expanded services offered.
   o Home Health and Hospice will have increased overall admissions by 5% for each program.

Objective 4: By May 31, 2018, WIC's Breastfeeding Peer Counselor Program (BFPCP) will establish
collaborative community partnerships dedicated to breastfeeding promotion and support which will result in
attaining a higher percentage improvement of infants who continue to breastfeed at six weeks of age.

Goal(s) Addressed:
  o Establish breastfeeding promotion and support activities within the Health Department and the
       community.
  o Increase rates of infants in the WIC Program who continue to breastfeed at six weeks of age based on
       the state fiscal year 2017-2018 Agreement Addendum.

Partners Involved:
   o Nutrition Services Branch state staff
   o Region IV Breastfeeding Consultant
   o Regional Nutrition Consultants
   o PCHD Nutrition and WIC Services Section staff
   o PCHD personal health staff
   o Person County Public Library
   o Media outlets
   o Community medical providers
   o Community partners (Person County Department of Social Services, Roxboro Housing Authority,
      Person County Partnership for Children, Christian Help Center, and local child care centers)

Activities:
   o Initiate a series of lunch 'n learn workshops focusing on breastfeeding initiation, concerns, and issuance
       of pumps and accessories.
   o Maintain a breastfeeding support system for pregnant, breastfeeding, and postpartum women.
   o Provide interested WIC participants with written literature and DVDs and dispense books to Health
       Department personal health staff and community medical providers.
   o Distribute PCHD WIC Prenatal and Postpartum Breastfeeding Support Services Referral Forms to
       Health Department staff, community medical providers, UNC Hospitals, Duke Regional Hospital, and
       Duke University Medical Center.
   o Design a breastfeeding bulletin board display in the WIC Office during World Breastfeeding Week,
       August 1-7, 2017.
   o Create a breastfeeding promotion and support display at the Person County Public Library during the
       entire month of December 2017.
   o
Desired Outcome(s):
   o Establishment of breastfeeding promotion and support activities within the Health Department and
       community.
   o Increased rates of infants in the WIC Program who continue to breastfeed at six weeks of age based on
       the state fiscal year 2017-2018 WIC Agreement Addendum.

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Objective 5: By June 30, 2018, participate in the Region V Minority Diabetes Prevention Program (MDPP)
Collaborative and fulfill requirements per the agreement addendum which includes implementing the evidence-
based diabetes prevention program, Prevent T2, with at least one group of participants.

Goal(s) Addressed:
  o Participate in the Region V MDPP Collaborative.
  o Increase the department’s capacity to address pre-diabetes and diabetes prevention.

Partners Involved:
   o Region V MDPP Regional Coordinator
   o Region V MDPP partnering counties
   o Cooperative Extension Service
   o Media

Activities:
   o Work with the Regional Coordinator and partnering counties to establish a plan and budget for fiscal
       year 2017-2018.
   o Participate in regional calls, meetings, and events.
   o Provide information and data for regional reports as required.
   o Manage local funds provided through the collaborative.
   o Promote the Prevent T2 program and recruit participation through a “session 0”, a media campaign,
       and/or contacting people on a waiting list.
   o Implement the Prevent T2 program.

Desired Outcome(s):
   o Requirements of the Region V MDPP Collaborative will be fulfilled.
   o At least 1 DPP will be implemented.

Objective 6: By June 30, 2018, increase by 20 % the number of clients who receive the Gardasil vaccine by age
19.

Goal(s) Addressed: Increase the number of Gardasil vaccines administered by the age of 19.

Partners Involved:
   o Clinical staff
   o Clerical staff
   o Foreign Language Interpreter
   o Private providers
   o Duke providers

Activities:
   o Increase Family Planning clinic hours by 1-2 evenings per month.
   o Advertise extended clinic hours.
   o Educate staff regarding their role in educating clients about Gardasil.
   o Educate/inform local providers about the availability of Gardasil.
   o Complete at least 1 Gardasil/immunization outreach within the county per fiscal year.

Desired Outcomes: The administration of the Gardasil vaccine will be increased by 20%.

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Objective 7: By June 30, 2018, begin working with the state on the implementation of Practice Management.

Goal(s) Addressed: Improve health outcomes, clinic efficiency, and provide cost effective services.

Partners Involved:
   o PCHD staff
   o North Carolina Division of Public Health - Local Technical Assistance and Training Branch staff

Activities:
   o Participate in site visits.
   o Continue to run and analyze clinical and financial reports as requested.
   o Implement Practice Management strategies as advised by the state.

Desired Outcomes:
    o The state begins providing consultation and advises the department on Practice Management strategies.
    o The department begins to implement some strategies.

Objective 8: By January 1, 2018, an increased percentage of staff members will report increased confidence in
their role as a public health responder specifically in regards to safety and agency capabilities than reported in
the previous year’s electronic preparedness survey.

Goal(s) Addressed:
  o Complete time period goals for Operation Rejection improvement plan.
  o Improve responder health and safety and other public health capabilities.
  o Continue partnership with Flu Near You for pandemic prevention.
  o Continue Medical Reserve Corps (MRC) Staying Alive and Pandemic Free Campaign and revisit
       Roxboro Community School (RCS) participation.
  o Restructure MRC for volunteer proficiency, collaboration, continuity.
  o Enroll public health employees into MRC.
  o Implement competency checks for all nursing skills agency wide.
  o Finalize Safety Program Policies and Procedures.
  o Complete time period goals for Star Annual Report.
  o Rectify all infection control deficiencies and implement best practices and staff compliance with
       regulation, advocacy, education and practice.

Partners Involved:
   o PCHD clients, visitors, and all staff
   o Local Emergency Planning Committee (LEPC)
   o MRC
   o Board of Health (BOH)
   o North Carolina Public Health Preparedness and Response (NCPHPR)
   o Person High School and Middle Schools (PHS)
   o RCS
   o National Association County and City Health Officials (NACCHO)
   o Skoll Global Threats and Health Map
   o Do 1 Thing
   o Other trusted community leaders participating in “The Conversation”
   o North Carolina Board of Labor (NCBOL)
   o UNC Spice and North Carolina Department of Health and Human Services (NCDHHS) Communicable
      Disease (CD) Branch of Healthcare Associated Infections (HAI)

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o North Carolina Department of Public Safety (NCDPS), Emergency Management (EM) Division

Activities:
   o Hands Only CPR Training.
   o Flu Near You Registration and Training.
   o Public Health Capabilities Training.
   o Continue Whole Community Inclusion Readiness for Individuals with Access and Functional Needs.
   o Design procedure for contract/temporary staff safety orientation and annual trainings.
   o Written Local Receiving Site (LRS) contract and workshop.
   o Re-audit for agency infection control.
   o Investigate ability to wear a respirator as a stipulation of pre-employment agreement.
   o Provide guidance for community partners on responder health and safety initiatives such as hoarding,
       respiratory protection, and NCBOL Star Program.
   o Convert Safety Data Sheets (SDS) to electronic format and format to Globally Harmonized System for
       compliance.

Desired Outcomes:
   o Improved confidence in public health and safety roles for daily and emergent conditions.
   o Transition MRC campaigns to project captains and volunteer management.
   o Public Sector Star renewed.
   o Increased community resilience through Flu Near You registration and Hands Only CPR.
   o Completely updated best practice supported safety program.
   o Improved community resilience through enhanced capabilities such as responder health and safety,
       MRC support, and infectious disease response.

Objective 9: By March 15, 2018, submit the 2017 State of the County Health (SOTCH) report and in the
following months, disseminate results in compliance with department policies and accreditation requirements.

Goal(s) Addressed: Determine the health status of the county and any emerging issues.

Partners Involved:
   o Health Education
   o Management team
   o Person County Economic Development
   o Media
   o NC State Center for Health Statistics (NCSCHS)

Activities:
   o Obtain the most current health statistics for the county from the NCSCHS.
   o Compile data and information into a report and submit to the state.
   o Comply with PCHD’s policy on the development and dissemination of the SOTCH report.

Desired Outcomes:
   o The SOTCH report will be submitted to the state and disseminated locally in accordance with the
       department’s policy.

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Objective 10: By December 31, 2018, the Person County WIC Program will implement the Electronic Benefits
Transfer (EBT) Program administered by the State Nutrition Services Branch.

Goal(s) Addressed:
  o Implement the WIC EBT (eWIC) Project under the guidance and consultation provided by the State
       Nutrition Services Branch.

Partners Involved:
   o Nutrition Services Branch state staff
   o Regional Nutrition Consultants
   o PCHD Nutrition and WIC Services section staff
   o PCHD WIC-approved local retailers (vendors)
   o Soultran Electronics Benefit Transfer Vendor

Activities:
   o Modify WIC Program clinic schedules as information technology projects progress.
   o Devise a contingency plan for unforeseen events.
   o Attend the "Just In Time" Training, webinars, and other continuing educational opportunities as
       scheduled.
   o Participate in educational buys at local retailers in advance of rollout project.

Desired Outcomes:
   o Successful transition from paper food instruments to EBT cards utilizing a mobile application on a
       smartphone.
   o Expansion with active WIC participation and a reduction in no-show appointments with eWIC's efficient
       processing.

Objective 11: By June 30, 2018, implement the first 3 phases of the Community Health Assessment (CHA)
process.

Goal(s) Addressed: Determine the health status of the county and any emerging issues.

Partners Involved:
   o Health Education
   o Management team
   o Community Health Assessment team
   o Contract consultant
   o NCSCHS

Activities:
   o (Phase 1) Establish a CHA team and begin meeting.
   o (Phase 2) Work with team to collect primary data from the community.
   o (Phase 3) Work with team and consultant to collect secondary data.

Desired Outcomes:
   o A CHA team will be functioning.
   o Primary and secondary data will be collected.

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Objective 12: On an ongoing basis, ensure that quality Environmental Health services are continually provided
in an efficient and timely manner in accordance with local and state regulations, and that support is provided to
other agencies/programs as required

Goal(s) Addressed: Maintain the efficient delivery of high quality Environmental Health services to the
citizens of Person County in order to promote and protect the environment and public health.

Partners Involved:
   o Person County Environmental Health staff
   o PCHD staff
   o Board of Health
   o General public
   o County and city departments
   o Septic and well contractors
   o Developers, builders, and real estate agents
   o Engineers, surveyors, and consultants
   o Division of Environmental Health, NC Department of Health and Human Services (NCDHHS)
   o NC Division of Environment and Natural Resources
   o US Environmental Protection Agency
   o Person/Granville County Stormwater Utility
   o Upper Neuse River Basin Association (UNRBA)

Activities:
   o Permit and conduct inspections of restaurants and institutions in compliance with state requirements
      (>350 inspections/yr.), and provide supporting data to NCDHHS.
   o Conduct requested on-site evaluations (>150/yr.) and design and permit systems.
   o Conduct septic system installation inspections (>100/yr.) along with site consultative visits
      (450/yr.).
   o Perform, document, and invoice for state mandated Pump Maintenance Inspections as requested.
   o Permit, inspect and sample new (>70/yr.) and existing wells and provide water quality health risk
      assessments.
   o Evaluate and permit building additions and mobile home replacements (>75/yr.).
   o Maintain a quality control program, participate in educational programs, and respond to information
      requests.
   o Maintain an inventory of county septic systems and work to identify and repair failing systems.
   o Conduct stormwater control structure inspections, support activities of UNRBA, and facilitate grant
      program.
   o Conduct environmental lead investigations in response to elevated child blood lead levels and in
      coordination with PCHD and NCDHHS staff.

Desired Outcomes:
   o Inspection rate of 100% will be maintained for all graded establishments (restaurants, facilities,
      daycares, pools, tattoo parlors).
   o Approvals or denials will be issued for all on-site evaluation applications within 15 working
      days of submittal.
   o Ensure that all requested pump system maintenance inspections are conducted within 15
      working days. Requested water samples will be collected with 5 workings days (new wells
      within 30 days of Operation Permit).
   o Applications for building additions and mobile home replacements will be evaluated within 10
      working days.
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o Respond to requests for file information within 2 working days.
    o Improved surface water quality in the Flat River Watershed and across Person County (reduced
      nutrient export).
    o Ensure that all public health, environmental, and stormwater rules and regulations are properly
      implemented.
    o Identify and recommend remediation of environmental sources of lead in order to protect the
      health and well-being of susceptible children.

                                Department Strengths and Weaknesses
The following strengths and weaknesses, that would be factors in the department’s ability to meet the
aforementioned objectives, were identified during the strategic planning process.

                       Strengths                                               Weaknesses

                                                         Funding uncertainty and reduction in federal, state,
Employees offering various levels of expertise
                                                         and local funding

Partners/local support for programs                      Change and reduction in staff

Support from national, state, and private consultants    New employee recruitment and retention

Board of Health support                                  Internal customer service

                                                         Lack of staff participation in trainings and other
Ability to access resources
                                                         professional opportunities

Adaptability to challenges

Grant and revenues – fiscal accountability

Training opportunities available to staff

Facilities

External customer service

Staff involvement beyond local duties – staff
contribute to state and national committees/efforts

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Appendix A:

   Status of 2016-2017
 Strategic Plan Objectives
and Outcomes/Explanations

                             15
Appendix A: Status of 2016-2017 Strategic Plan Objectives and Outcomes/Explanations

Objective 1: By June 30, 2017, a Diabetes Prevention Program (DPP) recognized by the Centers for Disease
Control (CDC), will be implemented with at least one group of participants.

   o Status: Partially Met
   o Outcome(s)/Explanation(s): Two partners (Quality Assurance Specialist/Health Educator, Health
     Department and Family and Consumer Science Agent, Cooperative Extension) were trained to become
     Lifestyle Coaches in order to be certified to deliver a CDC recognized DPP. The Health Department has
     actively participated in a regional Minority Diabetes Prevention Program collaborative and secured
     support to offer a DPP locally. A local DPP is scheduled to start in June.

Objective 2: By June 30, 2017, sustain or exceed the health department’s immunization rate goal of 90% for
children ages 24-35 months old as well as sustain or exceed the county’s immunization rate goal of 83% for the
same age group. Additionally, increase the number of adults immunized for the flu and pneumonia through the
health department by 5%.

   o Status: Partially Met
   o Outcome(s)/Explanation(s): Ninety-eight percent of 24-35 month olds active in the Health Department
     received recommended immunizations. Seventy-six percent of 24-35 month olds in the county received
     recommended immunizations. There was an 8% decrease in the number of adults receiving the flu
     immunization and a 28% decrease in the number of adults receiving the pneumonia immunization
     through the Health Department. (7/1/2015-4/30/2016 data compared to 7/1/2016-4/30/2017 data.)

Objective 3: By June 30, 2017, Home Health and Hospice of Person County will become reaccredited through
the Accreditation Commission for Health Care, Inc.

   o Status: Met
   o Outcome(s)/Explanation(s): Hospice was reaccredited in January 2017 while Home Health received
     reaccreditation status in February.

Objective 4: By May 31, 2017, WIC’s Breastfeeding Peer Counselor Program (BFPCP) will establish
collaborative community partnerships dedicated to breastfeeding promotion and support which will result in
attaining a higher percentage improvement of infants who continue to breastfeed at six weeks of age.

   o Status: Partially Met
   o Outcome(s)/Explanation(s):
          The WIC BFPCP is ongoing toward the establishment of collaborative community partnerships
             dedicated to breastfeeding promotion and support.
          The BFPCP position was temporarily filled from March 2016 to July 2016. This position will be
             readvertised at the request of the State Nutrition Services Branch on the Person County website
             and in the local newspaper.
          The PCHD WIC Program staff offered breastfeeding support to pregnant, breastfeeding and
             postpartum women.
          The Breastfeeding Coordinator and the Breastfeeding Peer Counselor designed a breastfeeding
             bulletin board display in the WIC office during World Breastfeeding Week, August 1-7, 2016.
          The number of infants that were enrolled in WIC who were breastfeeding at 6 weeks of age was
             84 or 33.47% last year which has decreased to 81 or 30.80%. This is a slight decline by 3
             participants or 2.67% within the past year.
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Objective 5: By August 1, 2017, both the Person County and Caswell County campuses of Piedmont
Community College (PCC) will be tobacco-free.

   o Status: In Progress
   o Outcome(s)/Explanation(s): PCC adopted a tobacco-free policy and preparations are being made for
     policy implementation in August 2017. Various Health Department staff along with the Region V
     Tobacco Prevention Manager have provided resources to PCC during this process.

Objective 6: By March 6, 2017, complete a State of the County Health report and in the following months,
disseminate results in compliance with department policies and accreditation requirements.

   o Status: Met
   o Outcome(s)/Explanation(s): The 2016 State of the County Health report was submitted in February and
     dissemination of the report occurred in the following months.

Objective 7: By June 30, 2017, begin working with the state on the implementation of Practice Management.

   o Status: Partially Met
   o Outcome/Explanation: Clinical and financial reports have been submitted to the Local Technical
     Assistance Branch of DPH. A state consultant has been assigned and is scheduled to visit on May 31,
     2017.

Objective 8: By January 30, 2017, 85% of staff members will report confidence or increased confidence in their
role as a public health responder in regards to their safety and overall emergency preparedness via an electronic
survey.

   o Status: Partially Met
   o Outcome(s)/Explanation(s): Staff will be surveyed in May/June to measure confidence in their role as a
     public health responder. The MRC partnered with Health Occupations Students of America (HOSA)
     students and local schools to implement the Staying Alive/Hands Only CPR and Flu Near You
     Campaign. The Public Sector Star application was renewed. There was an increase in community
     resilience through an increase in Flu Near You registrations and people trained in Hands Only CPR.

Objective 9: On an ongoing basis, ensure that quality Environmental Health services are continually provided
in an efficient and timely manner in accordance with local and state regulations, and that support is provided to
other agencies/programs as required, including the Person County Stormwater Program.

   o Status: Partially Met
   o Outcome(s)/Explanation(s):
      (Met) An inspection rate of 100% was maintained for all graded establishments (restaurants,
        facilities, daycares, pools, tattoo parlors).
      (Partially Met) Permits or denials were issued for all on-site evaluation applications within 14-28
        days of submittal.
      (Met) All requested pump system inspections are conducted.
      (Partially Met) Requested water samples were collected within 5 workings days (new wells within
        30-40 days of Operation Permit).
      (Met) Applications for building additions and mobile home replacements were evaluated within 10
        working days.
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 (Met) Requests for file information were responded to within 2 working days.
 (Met) Improved surface water quality in the Flat River Watershed and across Person County (reduced
  nutrient export).
 (Met) Ensured that all public health, environmental, and stormwater rules and regulations were
  properly implemented.

Note: Objectives will be reassessed at the end of the fiscal year as several that are “partially met” at the
time of this report will be “met” by that timeframe.

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