REPORT

FISCAL YEAR

2018

ANNUAL

PROMOTION

PREVENTION

PROTECTION

ABOUT US DATA COMMUNITY

OUTREACH

BULLITT COUNTY

HEALTH DEPARTMENT

Bullitt County Board of Health

Praveen Arla, DO

Margaret Beeler, RPh

Christine Albert Carnes, D.V.M.

Sarah Hart, MD

Raymond (Butch) Meyer, P.E.

Judge Melanie Roberts

Charles Ballard

Steve Binkley, D.M.D. (Chair)

Frances Flaherty, RN

Robert McDade, D.M.D (Vice-Chair)

Matthew Mooney, O.D.

Secretary/Treasurer: Andrea Renfrow,

MSN, RN

Awards and Honors

Andrea Renfrow, MSN, RN, Public Health Director was recognized in October 2017 by

the Kentucky Health Departments Association (KHDA) with the Trail Blazer Award. This

award recognizes and honors a creative and innovative Public Health Director who has

less than five years’ experience, who has demonstrated great leadership skills. The

award recognizes the qualities of loyalty, devotion and perseverance for the better-

ment of public health departments, with an impact on comprehensive public health

services.

Darlene Haley retired from our Board of Health in November 2017. She has served our

community for 11 years as a board member. We thank her for her work and

dedication to public health in Bullitt County!

In April, retired Health Educator Cynthia Brown received the David B. Stevens, MD

Smoke-Free Advocate of the Year award at the Kentucky Center for Smoke-Free

Policy’s spring conference. This award recognizes the work of local leaders and

organizations making progress in creating healthier, smoke-free communities. Cynthia

has been a smoke free advocate for Bullitt County for over 18 years!

The Board of Health drafted a new regulation regarding food establishment placards.

Establishments must post inspection scores in a place visible to the public and they

cannot be moved or concealed. This regulation goes into effect on January 1, 2019.

Healthy Bullitt County 2020

Vital Statistics

Leading Cause of Death Deaths

Malignant Neoplasms (Cancer) 151

Diseases of Heart 127

Chronic Lower Respiratory Diseases

72

Accidents (Unintentional Injuries) 61

Intentional Self-Harm (Suicide) 20

Year Births Deaths

2015 771 611

2016 842 659

2017 793 666

Top Five Leading Causes of Death for Residents§ of

Bullitt County, 2017 Number of Births and Deaths for Residents§ of Bullitt

County, Kentucky, 2015-2017*

* Natality and mortality data for year 2015, 2016, and 2017 are

preliminary and subject to change.

§ Resident mortality data includes deaths which have occurred to the

residents of a specific geographic area, regardless of the place of

occurrence

In Kentucky, the registration of births and deaths is maintained by the Office of Vital

Statistics from the Kentucky Department for Public Health. The local health department

maintains records of births outside of a hospital, declarations of paternity and

disinterments/reinterments in Bullitt County cemeteries.

Healthy Bullitt County 2020 workgroups continued

working towards the goals identified in our Commu-

nity Health Improvement Plan. The plan focuses on

four strategic issues:

Strategic Issue #1—Strengthen Community

Resources. The Inter-Agency Council continues to

serve as the lead group for the Community Health

Improvement Plan (CHIP) implementation process.

Strategic Issue #2 Healthy Choices—CREW is the lead coalition for this issue. Activities

included: FamilyFest, Maintain Don’t Gain Healthy Holiday Challenge, a survey of

physical activity barriers in the community, and multiple exercise classes.

Strategic Issue #3 Access to Care—The local Provider’s Coalition has absorbed this

workgroup and is working to recruit providers to the area. A naloxone training was held

and over 60 kits were distributed to first responders and community members.

Strategic Issue #4 Substance Abuse— Partners In Prevention is the coalition working on

this issue. Activities include: VIP Poster campaign and calendars, Red Ribbon Week,

promotion of the 100% 24/7 Smoke Free Schools policy, and other events such as

Hidden in Plain Sight and Generation RX.

Environmental Services

The BCHD Environmental Branch works to assure the health of the community by enforcing laws, regulations and ordinances that protect health and ensure safety. The Environmental Health Staff inspect: regular and temporary food service facilities; public swimming pools and beaches; schools; hotels and motels; mobile home and recreational vehicle parks; youth camps; and tattoo, body piercing and ear piercing studios. Environmental Health Staff investigate complaints concerning garbage, sewage and rodents. Additionally, as part of the rabies control program, they serve as quarantine officers in cases involving animal bites to humans.

Environmental Health Staff also work to protect surface and ground water by inspecting

the installation and repair of residential and commercial septic systems.

The Food Handler and Food Manager training went into effect in August 2015 with the

purpose of ensuring an educated food service workforce in the county. This fiscal year,

111 Food Managers were trained; a total of 643 have been trained since the program

began in fiscal year 2017.

749

1646

314187

0

200

400

600

800

1000

1200

1400

1600

1800

Food RelatedInspections

On-SiteInspections

GeneralSanitationProgram

Public FacilitiesInspections

Coun

t

Program Area

Environmental Health Activities for FY2018

Environmental Services

Food Inspections Count

Regular Inspections 375

Follow-up Inspections 96

Complaint Inspections 41

Consultation Inspections 94

Fair/Events Inspections 15

Other food inspections 17

On-Site Inspections Count

Site Evaluations 120

Permits 103

Inspections 168

Sewage Complaints 20

Visual Inspections 57

Consultation 869

Other 309

Public Facilities Inspections Count

Hotel/Motel 28

Mobile Home/RV Parks 14

Schools 58

Tattoo/Body Piercing Studios 7

Youth Camps 6

Pools 41

Consultation 33

General Sanitation Count

Nuisance Complaints 56

Rabies 95

Water Samples 13

Consultation 150

Have you ever wanted to know how a local restaurant scored on their health

inspection before you and your family head out to eat dinner? Up-to-date in-

spection scores for local restaurants and other facilities in Bullitt County are

available on our home page (www.bullittcountyhealthdept.org)

Clinical Services

Support staff are the first faces our clients see. Patient registration, scheduling

appointments, maintaining charts, processing and sending requests for medical

records, and immunizations are completed daily.

The clinic provides many services including:

• Immunizations for infants, children and adults

• Women, Infants and Children (WIC) services—supplemental food program for those meeting both income and eligibility guidelines

• Family planning—contraception, exams/screening, and pregnancy tests

• Well child exams—periodic health screenings from birth to age 21 (eligibility requirements apply)

• Cancer screening—cervical cancer screenings, clinical breast examination, mammography, and smoking cessation classes

• Tuberculosis (TB) - screening and/or testing as well as treatment if needed

• STD and HIV/AIDS—confidential testing and treatment for most sexually transmitted diseases, HIV counseling, testing and referral services if needed

Services Patients Served

Immunizations 701

Family Planning 219

WIC 1878

Tuberculosis 366

STDs 31

Cancer Screening 94

*unduplicated, unique patient count

HANDS

HANDS is a voluntary program for anyone expecting a baby or who has an infant

three months of age. The main goals of the program are:

• Ensure healthy pregnancies and births

• Promote healthy growth and development

• Ensure safe homes

• Support families in being self-sufficient

How do you join the HANDS program? During pregnancy or the first three months of

an infant’s life, families have an opportunity to meet with a parent visitor who can

explain the benefits of the program and ultimately connect them with a family support

worker, who will introduce vital parenting skills.

Nutritional Services

A Registered Dietitian is available for medical nutrition

therapy for: weight control, diabetes, pregnancy related

issues, elevated cholesterol, medication review, eating

disorders, and elevated blood lead levels. Nutrition/

metabolic conditions may include: nutrient deficiency

diseases, gastro-intestinal disorders, glucose disorders,

thyroid disorders, hypertension, renal disease, cancer/treatment for cancer, central

nervous system disorders, genetic/congenital disorders, inborn errors of metabolism,

infectious diseases, Celiac disease, recent major surgery, trauma or burns.

104111

105

114

123

9097

92

0

20

40

60

80

100

120

140

2011 2012 2013 2014 2015 2016 2017 2018

Coun

t

Fiscal Year

Number of Families Served

Statistics

Each year, the Robert Wood Johnson Foundation publishes County Health Rankings to educate and inform communities about their health status to: • Understand the health problems in their community • Get more people involved in improving the health of communities • Recognize that factors outside of medical care influence health • Reveal a snapshot of how health is influenced by where we live, learn, work and

play

Rankings consist of a Health Outcomes and Health Factors ranking. Health Outcomes

are a snapshot of today’s health. Health Factors look at tomorrow’s health and the

dynamics that will affect how healthy we are in the future. In 2018, Bullitt County was

ranked 5th out of 120 counties in Kentucky in health outcomes and 22nd on health

factors.

The Foundation also identifies areas for further exploration and for Bullitt County these include: adult smoking rate, adult obesity, excessive drinking and the ratio of primary care physicians to residents. These areas correspond to the Strategic Issues identified in the Healthy Bullitt County 2020 CHA/CHIP. These include: substance abuse issues (adult smoking rate and excessive drinking), healthy choices (adult obesity), and access to care (ratio of population to primary care providers).

17 17

25 25

27

6

9

5

26

31

22

24

21

18

2122

0

5

10

15

20

25

30

35

2011 2012 2013 2014 2015 2016 2017 2018

Ra

nk

Bullitt County Health Rank Trend

Health Outcomes Ranking Health Factors RankingHow we're doing now

More

healthy

Less healthy

How we will do in the future

Bullitt County Demographics

Total Population 80,246 US Census Bureau, 2017

Male 39,802 (49.6%)

US Census Bureau, 2017

Female 40,444 (50.4%)

US Census Bureau, 2017

<5 years 4,173 (5.2%)

US Census Bureau, 2017

<18 years 17,734 (22.1%)

US Census Bureau, 2017

≥65 years 12,197 (15.2%)

US Census Bureau, 2017

High school graduate or higher

86.7% US Census Bureau, 2012-2016

Bachelor’s Degree or higher 14.2% US Census Bureau, 2012-2016

Unemployment 4.1% 2018 County Health Rankings

Per capita income $25,805 US Census Bureau, 2012-2016

Median household income $58,702 US Census Bureau, 2012-2016

Persons below poverty level

10.4% US Census Bureau, 2017

Health Measures

Adult smoking rate 20% 2018 County Health Rankings

Adult obesity 36% 2018 County Health Rankings

Physical inactivity 30% 2018 County Health Rankings

Excessive drinking 17% 2018 County Health Rankings

Teen births (per 1,000 females 15-19) 28 2018 County Health Rankings

Uninsured 5% 2018 County Health Rankings

Diabetic monitoring 85% 2018 County Health Rankings

Mammography screening 59% 2018 County Health Rankings

Health Education

Health Education seeks to improve our community through: • Encouraging individuals and populations to make healthy choices, engage in

healthy behaviors and seek preventive care • Interacting with the community and representing health education at community

events, councils, coalitions and schools • Developing, managing, and evaluating health education programs and services,

health risk assessment tools, educational materials and curricula (e.g., printed, audiovisual, or web-based), and communication campaigns

• Conducting research as appropriate for program planning, implementation, and evaluation as well as marketing health programs and services

Grants Awarded Amount

Title V Abstinence Education Grant $24,265 KIPDA Title III Services $12,160 CARE Collaborate Grant $5,000 KY Tobacco Prevention and Cessation Program Local Grant

$25,000

WellCare Grant $1,500 Diabetes Coalition Grant $2,500

Health Education

Event # Served

*Positive Potential 693

Diabetes 101 17

*Healthy Hearts Wear Red Luncheon

261

“Think Pink” 152

*Freedom From Smoking

6

Growing Stronger Exercise Program

23

*Arthritis Exercise Program

51

Weight Loss Competition

48

Puberty & Hygiene 804

Safe Sitter 40

Dental Screenings 1750

Dental Education 3485

Handwashing 3318

Health Fairs 5100

*Walk With Ease 16

Go365 Biometric Screenings

474

*CARE 543

Diabetes Walk 52

Bingocize 102

* Partially grant funded

Event # Served

Exercise Demonstrations 175

STI Presentations 270

Contraceptive Choices 270

Family Fest 218

Inter-Agency Meetings 133

CREW Coalition Meetings 51

Partners in Prevention 150

Epidemiology Our epidemiology department is responsible for routine communicable

disease surveillance. Results of routine surveillance allow us to better under-

stand the burden of illness in our community and helps us design and imple-

ment effective programs to reduce this burden. Our epidemiologists also con-

sult with local healthcare providers about communicable diseases.

The Epidemiology Rapid Response Team is a multi-disciplinary team trained

to respond to community health threats rapidly and effectively.

* Confirmed and probable case counts. Counts are preliminary and are subject to change.

2015 2016 2017 2018

Bloodborne

Acute Hepatitis A 0 0 0 42

Acute Hepatitis B 0 2 2 6

Acute Hepatitis C 0 7 8 12

Chronic Hepatitis B -- 4 6 6

Chronic Hepatitis C -- 48 91 124

Foodborne/Waterborne

Campylobacteriosis 5 3 2 9

Cryptosporidiosis 1 0 1 0

Salmonellosis 12 7 13 12

Shiga-toxin E. coli 0 2 1 2

Shigellosis 0 0 9 4

Respiratory and Invasive

Haemophilus influenzae 0 1 1 4

Influenza 4 1 14 25

Legionellosis 2 1 0 1

Streptococcus pneumoniae 2 5 5 12

Sexually-Transmitted Infections

Chlamydia 172 176 157 172

Gonorrhea 25 35 69 52

Syphilis (all stages) 2 2 2 3

Vaccine-Preventable

Mumps 0 1 1 0

Pertussis (Whooping Cough) 1 1 1 1

Vector-borne

Ehrlichiosis/Anaplasmosis 2 1 3 3

Lyme Disease 1 0 1 2

Rocky Mountain Spotted Fever 2 1 4 10

Zoonoses

Rabies post-exposure prophylaxis -- 2 3 6

Emergency Preparedness

Our local Medical Reserve Corps (MRC) also provides a vital service to the community.

Hosted at the health department, the MRC is a volunteer organization that:

• Supports public health committees and programs

• Trains for events and maintains emergency equipment

• Recruits and encourages others to join

In the event of an emergency, MRC members:

• Receive critical items such as medications, vaccines, or masks from state and federal stockpiles and redistributes them to the public

• Support the American Red Cross and the county in emergency shelters with special medical needs

• Assist when the local hospital or nursing homes experience an emergency or other bed shortage

• Staff phone banks to provide health and medical information

• Monitor the environment for safe food, water, and sanitation

Public health emergency preparedness (PHEP) is the

capability of the public health and health care systems,

communities, and individuals, to prevent, protect against,

quickly respond to, and recover from health

emergencies, particularly those whose scale, timing or

unpredictability threatens to overwhelm routine

capabilities (2007 American Journal of Public Health).

The health department receives support in three primary areas:

Public Health Emergency Preparedness (PHEP 821)

• Development of public health specific emergency plans

• Implementation of the National Incident Management Systems (NIMS/ICS)

• All hazards preparedness training for staff

Strategic National Stockpile/Cities Readiness Initiative (SNS/CRI 876)

• Mass vaccination and prophylaxis planning and training

• Stockpiling of various personal protective equipment (PPE), vaccines, or antivirals

Medical Reserve Corps (MRC 823)

• Develop and train volunteers to support health department programs

Financials

Expenses

Revenue

Personnel—$1,292,875

Fringe—$959,015

Contracts—$6,311

Capital—$24,303

Administrative—$199,364

Other—$358,889 45%

34%

13%

7%

1%

State—$600,093

Federal—$562,747

Local—$1,687,974

Medicaid—$196,530

Other—$105,161 54%

18%

19%

3%

6%

Bullitt County Health Department

181 Lees Valley Road

Shepherdsville, KY 40165

Clinic

Phone: 502-955-7837

Fax: 502-543-2998

Administration

Phone: 502-955-7837

Fax: 502-543-2449

Health Education

Phone: 502-955-5355

Fax: 502-543-2449

Environmental Health

Phone: 502-955-7867

Fax: 502-543-2449

HANDS

Phone: 502-955-5668

Fax: 502-543-2449

facebook.com/bullittkyhealth @BullittKYHealth www.bullittcountyhealthdept.org

Our Vision Statement

The Bullitt County Health Department strives to be a key public health

strategist in the areas of prevention, protection, and health promotion.

Our Mission Statement

“To promote healthy lifestyles in Bullitt County through prevention and

protection.”