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					                 2010
Cudahy Health Department
     Annual report




           Cudahy Health Department
                 PO Box 100510
              5050 South Lake Drive
             Cudahy, WI 53110-6108
              Phone: 414-769-2239
                Fax: 414-769-2291
       Email: health@ci.cudahy.wi.us
 The Cudahy Health Department’s mission is to
help the citizens of our community achieve their
            highest level of well-being.



We envision: strong families in safe neighborhoods
     with access to affordable health care.



    Our goal is to prevent injury, disease and
 premature death through health education and
       the promotion of healthy lifestyles.
                 2010 CUDAHY HEALTH DEPARTMENT ORGANIZATION CHART

                                              BOARD OF HEALTH

Gerald Ponec, Chairman                                                          Neil White, Secretary

Michael Johnson, DVM                                                            Lynn Damitz

Rebecca Owen                                                                    Ald. Mary Schissel

Robert Grams, School District Liaison                                           David Sherman, MD

                                        Carol Wantuch, Health Officer

                                         HEALTH DEPARTMENT STAFF


Medical Advisor:                                                                Health Officer:
David Sherman, MD                                                         Carol Wantuch, RN, BSN, MS

                                              Public Health Nurses:

Annette Schmidt, RN, BSN                                                        Mary Juleen, RN, BSN

                                              Cheryl Orlando, RN, BSN


                                           Health Department Clerk:
                                                   Linda Lindsey

Grant Coordinator:                                                  Environmental Health Specialist:
Edward Wrench, RN, BSN                                                      Martin Zabkowicz, RS

                                                   WIC STAFF


WIC Director:                                                             Breast-Feeding Coordinator:
Heidi Zimmer, RD, CD                                                            Debi Coon, DTR, IBCLC

Nutritionists:                                                                  Health Screener:
Laura Diamond, RD                                                                 Itaska Wright
Nicole Weeks, RD

Project Assistants:                                                       Breast-Feeding Peer Counselor:
Sally Severson                                                              Michelle Cummings, IBCLC
Abeer Bazar
Volunteers:


Our volunteers willingly give of their time and talents to our Health Department. Their devotion to us is truly a
gift. A sincere thank you to each of them!




                                    Thank You for Your Help!

                                                 Richard Haske



                                                    Tillie Jost



                                               Camille Prodzinski



                                               AND ESPECIALLY:

                                                Barbara Wegner
Health Officer’s Report to the City of Cudahy:
2010 was a challenging year for the Cudahy Health Department.



                                            Early in 2010, our Department was again formally recognized as a Level III
                                            Public Health Department by the Wisconsin State Department of Health.
                                            The presentation was held during the February 18, 2010 Cudahy Common
                                            Council meeting. The Cudahy Health Department is acknowledged as being
                                            one of the best local health departments in the State.


Georgia Cameron, Southeastern Regional Office & Carol Wantuch


Early in March 2010, the Health Department was notified about the possibility of an outbreak of Legionnaire’s
Disease. The source of this infection that impacted eight (8) patients from five suburban communities was a
decorative water feature at Aurora St. Luke’s South Shore. Over 68.8 hours of Public Health Nursing and
Health Officer time was spent investigating this outbreak and coordinating efforts with St. Luke’s South Shore,
Aurora Health Care, the Wisconsin Division of Health, our Environmental Health Specialist and the Wisconsin
Laboratory of Hygiene.




                                 June 17, 2010, I was honored to receive the WPHA’s (Wisconsin Public Health
                                 Association) Distinguished Service to Public Health Award. The nomination
                                 came from other Milwaukee County Health Officers as well as from the
                                 Cudahy Health Department staff. The Health Department staff organized a
reception for the presentation at the Cudahy Family Library on June 17th. This award came as a complete
surprise to me and I will treasure this recognition.

And of course, no year would be complete without some type of emergency management situation. This year
it was the July 22 & 23 floods that caused Milwaukee County to be declared a federal disaster area. Once
again, it was time to collect flood data, issue safety warnings about clean up of debris and offer flood clean-up
kits.

By fall of 2010, the Health Department was attempting to put together a 2011 budget that kept the
Department staff intact and services available to our residents. An unexpected opportunity arose to provide
Public Health Nursing services for the School District of Cudahy for which the Department would be
reimbursed. It was an option that could not be ignored and was approved by the Cudahy Board of Health.
Fortunately, with this change in staff budgeting, the Health Department remained intact and our budget was
passed.

2011 is going to be a time to up-date our policies and procedures and plan for the possibility of grant funding
decreases and possible municipal budget changes in the Department. It is also going to be a time to start
succession planning for my position. As of this writing, I have spent almost 23 years at the Cudahy Health
Department. I have loved almost every moment of my time here but it is time for my retirement which I hope
to take by the middle of 2012.



Carol Wantuch, Health Officer
Medical Advisor’s Report to the Community

It is clear from the events in Madison and Congress that we will all have to make do with less help from the
government. While medical costs increase, insurance coverages do not. Each of us will have to take a greater
stake in our own health and well being. Preventing common health problems is cheap and simple. Treating
them is complex and expensive, and you will pay more of the costs yourself.

The most common cause of death in adults is heart disease. This is followed by cancer and strokes. You
know how to prevent it: eat smarter, exercise, control your blood pressure and stop smoking.

Eat smarter: This doesn’t always mean less. A healthy diet is high in fiber and low in fat. Each day, try to eat
six to 11 servings of bread, rice and pasta, two to four servings of fresh fruit, three to five servings of
vegetables, two to three servings of non-fat milk, low-fat yogurt and low-fat or non-fat cheese, and two to three
servings of lean meat, poultry, fish, dry beans and egg whites. Buy fresh produce from the farmer’s market.
Avoid fast foods.

Exercise: The heart is a muscle and needs regular exercise to stay healthy. Aerobic exercise, such as brisk
walking, jogging or biking, gives the heart the best workout. Start small. Walk to the corner twice a day. Park
in the back of the parking lot. Use the stairs if you are able. Increase your activity weekly. Try to exercise with
a friend.

Blood pressure: Diet and exercise are often effective. Your doctor may recommend other measures.

Quit smoking: Smoking doubles your chance of a heart attack and greatly increases your risk of cancer. If
you’re not ready to quit, try smoking half as much. Ask your doctor for help. Quitting isn’t easy, but new
medications have made it much easier than it was. See the Quit Plan below.

These measures will reduce your chance of developing cancer. Cancers found early are often treatable. It’s
much harder if they are found late. If you are over 50, get your colonoscopy. If you are a woman, get your
mammogram. If you are a man, ask your doctor about prostate cancer.

One of the most common causes of death for all ages is motor vehicle accidents. Again, the changes are
simple. Wear your seat belt. Do not have more than one drink and then drive. Drive at the speed limit. Don’t
tailgate. Keep your car in good repair. As you get older, plan your trips ahead of time. Take a driver safety
class, some are listed below. You might even get a discount on your insurance.

Information on these topics and more are available from your health department. With a little smarts, a little
effort, and a little help from your doctor, you can give yourself a longer, healthier life.

Take a driver safety class.
To learn how to drive more safely, try taking a class. In a driver safety class, the instructor teaches you skills that you can
use when you are driving. To find a class near you, call one of the following programs:

      AAFP 55 Alive Driver Safety Program            1-888-227-7669

      National Safety Council Defensive Driving Course            1-800-621-7619

      Driving School Association of the Americas, Inc. 1-800-270-3722

      AAA Safe Driving for Mature Operators Program

      Call your local AAA club to find a class near you
 Prescription: Quit Smoking
 Quit Date: ________________________

 Just before your quit date:

 • Write down your personal reasons for quitting.
 • Look at your list often. •
 • Keep a diary of when and why you smoke.
 • Get rid of all of your cigarettes, matches, lighters and ashtrays.
 • Tell friends and family that you’re going to quit and what your quit date is.
 • Get the medication you plan to use.
 • Begin taking your medication.
 • Practice going without cigarettes in places where you spend a lot of time, such as your home or car
 • Call 1-800-QUIT-NOW for free materials and counseling.


 On your quit date:

• Stop smoking!
• Take your medication.
• Ask your friends, co-workers and family for support.
• Change your daily routine.
• Avoid situations where you’d typically smoke.
• Drink plenty of water.
• Stay busy.
• Do something special to celebrate.


 Right after you quit:

 • Develop a clean, fresh non smoking environment around yourself, at work and at home.
 • Try to avoid drinking alcohol, coffee or other beverages you associate with smoking
 • If you miss the sensation of having a cigarette in your mouth, try carrot or celery sticks, flavored tooth-picks or a
   straw.
 • Chew sugarless gum or mints to help with cravings.
 • Stay away from people who smoke.
 • Reward yourself for successes—one hour, one day or one week without smoking.
 • Start an exercise program


 David Sherman, MD

 Medical Consultant

 Cudahy Health Department
                                   Public Health Is Everywhere in Cudahy

The Health Department has 3 full-time public health nurses, 1 full-time Health Officer, 1 full-time secretary, 1
full-time grant nurse, 1 part-time sanitarian and 7 WIC staff.

.In 2010, the Cudahy Health Department:

   Investigated 349 cases of communicable diseases in Cudahy.
   Spent 68.8 hours investigating and controlling the Legionnaire’s disease outbreak.
   Offered 660 doses of routine immunizations and 57 TB skin tests to Cudahy residents.
   Collaborated with private providers, schools & childcare providers and improved Cudahy children’s
    immunization status by 5%.
   Offered 419 doses of seasonal flu and 3 doses of pneumonia vaccine.
   Offered 194 doses H1N1 vaccine and spent 122.4 hours in H1N1 management and control.
   Spent 493.3 hours of active participation in Cudahy Emergency Management activities & response as well
    as in public health emergency response.
   Spent 55.85 hours responding to the July flood.
   Provided health education through 13 classes for 185 participants, City of Cudahy newsletter & display
    boards.
   Provided nursing clinics for 90 residents in 3 of the Cudahy senior housing complexes.
    Spent 29.5 hours providing breast cancer screening services to women who do not have health insurance
    coverage through the Wisconsin Well Woman Program.
   Investigated several cases of human health hazards and works to abate those hazards.
   Collected 441 “sharps” from Cudahy residents through a DNR program and properly disposed of them.
   Oversaw the Cudahy/St. Francis Kiwanis hospital equipment lending service.
   Offered refugee screening for new Cudahy residents.
   Applied larvicide to all Cudahy catch basins to help prevent West Nile Virus.
   Investigated 40 animal bites.
   Inspected and licensed 232 Cudahy food service businesses.
   Inspected and licensed all Cudahy rooming houses.
   Inspected and licensed 25 scales, 181 gasoline pumps and 22 scanners in Cudahy.
   Provided inspection & replacement if necessary, of 230 child passenger safety seats.
   Provided pedestrian safety classes to all Cudahy elementary schools in conjunction with Safe Kids of
    Wisconsin’s “Walk This Way to School” program with 247 participating in the walk.
   Offered 200 bicycle helmets with appropriate fitting in conjunction with Cudahy Police.
   Partnered with the Cudahy Fire Department to “Deliver Fire Prevention”.
   Provided WIC (Women, Infants & Children) Program to 4,774 residents in southeastern Milwaukee County.
   Offered pregnancy-related services which include pregnancy testing, referrals for health insurance and
    Prenatal Care Coordination to pregnant 17 Cudahy residents.
   Offered blood lead testing to 229 age-appropriate children and did follow-up on 9 children with elevated
    blood lead results.
   Provided lead dust testing for 5 homes built before 1957 in which infants, preschool children or pregnant
    women live.
   Offered free lead-safe work practice classes to 7 Cudahy homeowners, contractors & rental property
    owners.
   Housed outreach workers who assist residents in applying for BadgerCare.
   Offered public health nursing services to 13 families of children with special health care needs.
   Offered annual respiratory testing for Cudahy Fire & Police Departments as well as any other City
    employee who needs to use a respirator.
   Spent 134.6 hours as the District Nurse for the School District of Cudahy.
In 2010:

The municipal expenditures for the Cudahy Health Department were $407,251.00.

The Health Department generated $117,577.00 in revenue.

The Health Department oversaw $875,580.00 in grant funding to provide services for our residents that we
could not otherwise provide.
Public Health Nursing Visits:




In 2010, three Cudahy Public Health Nurses (PHN’s) made a total of 716 visits to 281 clients. This is
comparable to the number of visits made in 2009. However, the number of clients who received services in
2010 decreased by 9% from the number who received services the prior year. As this graph illustrates there
are a number of increases and decreases in the types of visits that were made but this also relates to the
unknown variety of situations that the Health Department faces daily.

During 2010, illness and emergency family leave situations decreased our public health nursing staff by 547.9
hours (68.5 days) or 0.263 FTE’s. These situations were unavoidable and unplanned but as illustrated, they
unfortunately impacted service delivery in all of our activities.

Maternal and Child Health (MCH) again decreased by almost 22%. Health Department PHN’s, however, spent
116 hours working with high – risk pregnant clients to assure healthy birth outcomes. 216 babies were born
to Cudahy mothers in 2010. 55.09% of those infants were females and 44.91% were males. Five (5) sets of
twins were born in 2010. 82% of pregnant women received medical care in their first trimester. Almost 57%
of the pregnant mothers were married. 18 Cudahy babies were born prematurely with 16 of those infants
having low birth weights. Three (3) of the mothers were under 17 years of age which is a slight decrease from
2009.

Fifty (50) hours were spent assisting families of children with special health care needs. Seven children
needed our services to help coordinate their health needs care.
This year, the City had the greatest                            Comparison of Animal Bites
amount of animal bites since the
Health Department began tracking              40


them. Eleven of the bites were                35
caused by dogs. Six of those dogs
were Pit Bulls. The rest of the dogs          30


were a variety of breeds from                 25
Chihuahuas to German Shepherds.
There was also a bite from a coyote           20
                                                                                                             on
the bicycle trail at Warnimont Park.          15


The Health Department staff                     10

continues to work closely with the
Cudahy Police Department, the                    5


Emergency Department at St. Luke’s               0
South Shore Hospital and the             # of Bites
                                                    2004
                                                     32
                                                          2005
                                                           25
                                                                  2006
                                                                   35
                                                                         2007
                                                                          26
                                                                                 2008
                                                                                  31
                                                                                        2009
                                                                                         25
                                                                                                2010
                                                                                                 40
Cudahy Environmental Health
Specialist to assure that the offending animal is quarantined, immunized and licensed. The Health Department
also works with the individuals who were bitten to assure that they have needed medical care.

The table below illustrates the variety of sources of referrals for public health follow-up.

Referral Sources                       2006            2007              2008                2009   2010
Self                                    193             119               111                 104    92
Family/Friend                            97             114                92                  78    40
Case-Finding                              2               7                 4                   8     7
Physician                                 6               3                 2                   5     8
Hospital                                 27              16                35                  17    20
Community Agency                          8               3                 5                   7     8
School/Daycare                            3               4                 4                   6    12
Public Health                            79              71                62                  89    77
WIC                                       0              21                 9                  11     7
Lab                                       0              14                20                  26     3
Other                                   103              76                52                  40    63


The Health Department may discontinue services for a variety of reasons. The table below illustrates those
reasons.

Closure Reasons                        2006            2007              2008                2009   2010
Expired                                   0               0                 3                   1      0
Moved Out of Area                        13              16                14                  11     19
Moved, Not Found                          9              12                 6                  10      9
Goal Obtained                           256             222               137                 214    165
Services Refused                         36              45                24                  13     18
Single Visit                             89              82                86                  61     56
Other Assuming Care                      57              50                47                  61     49
Outcome Incomplete                       25              15                 3                  11     12
Other                                     6               3                 3                  11      6
Acute Communicable Disease:
Wisconsin State Statute 252.03 states that a local health department “upon the appearance of any
communicable disease in his or her territory shall immediately investigate all circumstances and do what is
reasonable for the prevention and suppression of disease.” Chapter DHS 141 lists ninety-one reportable
diseases in the State of Wisconsin.

In 2010 Cudahy PHN’s spent 171.6 hours investigating and controlling communicable diseases.



Diseases                                                      2006       2007        2008       2009      2010
Babieosis                                                       0          0           1          0         0
Campylobacter                                                   3          2           1          3         1
Chlamydia                                                       0          0          53         45        47
Cryptosporidium                                                 2          1           0          0         0
Dengue Fever                                                    0          1           0          0         0
E-Coli                                                          0          2           0          1         0
Ehrlichiosis                                                    0          0           0          0         1
Giardiasis                                                      0          0           1          0         0
Gonorrhea                                                       0          0           7          5         6
Haemophilius Influenzae, Invasive Disease                       0          1           0          0         0
Hepatitis A                                                     1          0           1          1         0
Hepatitis B                                                     0          2           2          4         0
Hepatitis C                                                     8         19          12          6        12
Influenza – Novel Influenza A                                   0          0           0         80         0
Legionnaires                                                    1          0           0          1         4
Lyme Disease                                                    1          0           2          3         4
Measles                                                         0          0           1          0         1
Meningitis, Viral                                               2          1           1          0         0
Meningitis, Bacterial                                           0          0           1          0         0
Mumps                                                           4          0           1          0         0
Mycobacterial Disease (Non-TB)                                  0          1           8         15         0
Norovirus                                                       0          0           0          0         1
Pertussis                                                       0          3           1          1         9
Salmonella                                                      3          0           1          3         2
Shigella                                                        1          3           1          3         0
Streptococcus Pneumoniae                                        3          3           9          6         5
Syphilis                                                        0          2           1          2         0
TB – Latent                                                     1          2           0          5         9
Varicella                                                       0          0           2          3         3
Vibriosis                                                       0          0           0          0         1


Novel H1N1 Influenza Virus:

Although the H1N1 virus outbreak was waning in 2010, the Cudahy Health Department did conduct two
additional H1N1 immunization clinics as well as offer the vaccine in our routine immunization clinics. In total,
an additional 201 doses of this vaccine was administered. Health Department staff did continue our H1N1
surveillance until mid-summer of 2010. 122.4 hours of staff time were spent coordinating H1N1 activities.
Sexually Transmitted Infections:
                                                                    Comparison of Incidences of Sexually Transmitted Infections
In 2010, there was an almost 43% increase in                50
the incidences of Sexually Transmitted                      45

Infections (STI’s). The largest increase was a              40

jump in the number of cases of Chlamydia.                   35

Some of this increase can be attributed to                  30

better detection. Unfortunately many of our                 25

clients with Chlamydia have had it multiple                 20

times despite Health Department instructions                15

on how to avoid this disease. 7.2 hours were                10


spent investigating cases of Gonorrhea and                      5


59.7 hours were spent investigating cases of                    0
                                                                      2003     2004    2005     2006     2007     2008    2009    2010
Chlamydia.                                          Chlamydia          19       27      21       24       32       41      32      47
                                                    Gonorrhea           6       2        4        2       12       7        5      6
                                                    Syphillis           0       0        0        0       1        1        0      0



Legionnaires Disease Outbreak:

On March 9, 2010 the Cudahy Health Department was notified of an increased number of reported laboratory
confirmed cases of Legionnaires Disease among residents of southern Milwaukee County. Using
epidemiological methods, one common link between all of the patients with this disease was identified. Most
of them had visited St. Luke’s South Shore Hospital during their incubation periods. Our Environmental Health
Specialist and an epidemiologist from the Wisconsin Department of Public Health went to the hospital to obtain
multiple water samples in an attempt to identify the source of the infection. Two potential sources were
identified: the decorative wall fountain in the hospital lobby or a water source in the hospital’s cancer clinic.
                                                      St. Luke’s South Shore voluntarily shut the water fountain
                                                      off on March 10, 2010.

                                                      As of March 12th, there were eight (8) cases of laboratory
                                                      confirmed Legionnaires infection. Two patients were from
                                                      Cudahy, 3 were from Oak Creek, 1 was from Greenfield, 1
                                                      was from South Milwaukee and 1 was from Franklin. All
                                                      of these individuals were hospitalized as a result of this
                                                      disease with five patients admitted to the Intensive Care
                                                      Unit.

                                                      Cudahy Health Department staff worked with St. Luke’s
                                                      South Shore, Aurora Health Care, the Wisconsin State
                                                      Health Officer and other State Department of Health
                                                      personnel to identify other potentially exposed individuals.

By March 17, 2010, the Wisconsin State Laboratory of Hygiene identified Legionella pneumophilia in the water
samples from the decorative water fountain in the hospital lobby. Aurora Health Care did voluntarily shut
down decorative water features at all of their facilities.

From 3/9/3010 to 4/5/2010, Cudahy Health Department personnel spent 68.8 hours managing this outbreak.
Of this time, one PHN spent 22.2 hours managing Cudahy infected individuals and the Health Officer spent 36
hours coordinating with St. Luke’s South Shore, the Wisconsin Department of Health, the other involved
communities and the media.
Telephone Information Calls:

                                                            Comparison of Telephone Information Calls

Information calls continue to be one                       1600

of the ways that Cudahy residents
                                                           1400
obtain health-related information.
                                                           1200

In 2010, information calls decreased
                                                           1000
only by 1% from 2009 calls. Many
                                                            800
of the calls related to H1N1, the
2010 flood clean-up and the                                 600

Legionnaire’s Disease outbreak.                             400


                                                            200


                                                              0
                                                                   2006      2007       2008       2009    2010
                                         # of Calls                1074      1232       1299       1518    1500
                                         Amt of PHN Time in Hrs.   197.8     222.1      209.7      225.5   220.7


Clinics:




Clinic settings continue to be the most efficient means of delivering public health services to our community.
There was an almost 55% decrease in the 2010 clinics compared to the 2009 clinics. However, this
discrepancy can be attributed to the large number of clients who were seen in the 2009 H1N1 immunization
clinics. Also there was a decrease in the number of residents seen in Nursing Clinics which was attributable to
a medical leave of one of our PHN’s.
Immunization Clinics:




Abbreviations: DTaP (Diphtheria-Tetanus-Acellular-Pertussis); Tdap (Tetanus-Diphtheria –Acellular Pertussis); Td (Tetanus-
Diphtheria); MMR (Measles-Mumps-Rubella); IPV (Inactivated Polio Vaccine); Hib (Haemophilius Influenza); HBV (Hepatitis B Vaccine);
HAV (Hepatitis A Vaccine); PVC (Pneumococcal Vaccine); VAR (Varicella Vaccine); MCV (Meningococcal Vaccine); HPV (Human
Papillomavirus Vaccine); RV (Rotavirus Vaccine)

If one discounts the number of H1N1 Virus Vaccine given in 2009 and 2010, there is only an 8 dose difference
between those years.

Because of how the vaccine is supplied to local public health agencies through the State of Wisconsin, clients
who attend Cudahy Health Department Immunization Clinics are asked a brief summary of what type of health
insurance coverage they have.

Disregarding H1N1 vaccine administration for 2009 and 2010 during the outbreak, the next chart illustrates the
insurance coverage of our immunization clients.
The Health Department charges a $15.00 vaccine administration fee for each client seen, regardless of the
number of vaccines that they receive. If a parent or client indicates that they cannot afford this administrative
fee, it is waived. The chart below illustrates the changes in a client’s ability to pay. This seems to be reflective
of the present economy.

                                                                                                                       NUMBER

                                                                                                   60


                                                                                                   50


                                                                                                   40


                                                                                                   30


                                                                                                   20


                                                                                                   10


                                                                                                    0
                                                                                                         2005           2006
                                    TB Skin Tests Given                                     Clients        8             22
                                                                                            # of Shots    15             46
            100

             90


                                                                                     TB Skin testing is done to
             80

             70

             60

             50
                                                                                     identify individuals who may
             40                                                                      have been in contact with
             30

             20

             10

              0

                  2006       2007            2008         2009    2010
     # of Tests    66         91              84           62      57
      someone with active TB disease.

      Tests are normally given to employees, healthcare workers, EMT’s and police personnel.




      Flu Clinics:
      The 2010 flu clinic was held on October 12th. The Health
      Department contracted with Wheaton Franciscan Home
      Health Services for the delivery of our community clinic as
      well as clinics at each of the Cudahy senior housing
      complexes.

      The Health Department concentrated on administering flu
      vaccine to children, City employees, local CBRF’s (Community
      Based Residential Facility) as well as any homebound
      residents and their caregivers.

                                                                                              Unfortunately 2010 clinics followed
                                           Flu & Pneumonia Vaccine Statistics
                                                                                              the trend with less people attending
                             1400                                                             our clinics. There was almost a
                                                                                              15% decrease in attendance.
                             1200
                                                                                              This trend is probably due to the
                             1000
                                                                                              number of private agencies and
                                                                                              stores that are offering flu vaccines
Number of Doses Given




                              800
                                                                                              to people grocery shopping or
                                                                                              picking up prescriptions, etc.
                              600
                                                                                              As a result of this decrease, the
                                                                                              Health Department will be cutting
                              400
                                                                                              clinic hours again in 2011.

                              200                                                             Despite the low clinic attendance,
                                                                                              the Cudahy Health Department did
                                0                                                             collect a fairly large amount of non-
                                    2004    2005      2006     2007      2008   2009   2010
                                                                                              perishable food and toiletry items
                        Flu          491    1314       919      753       498    491    419
                                                                                              for Project Concern.
                        Pneumonia    16      21         6       15        14      4      3
Nursing Clinics:                                              Comparison of Nursing Clinic Visits

Nursing Clinics are held at three of          160

Cudahy senior housing complexes:
                                              140
Washington Square, Evergreen Square
and Williamstown Bay. A PHN visits the        120


residents of each of these properties         100

once every three months to provide             80
nursing assessments and health
education for the residents on an              60


appointment basis.                             40


                                               20
Although most of these residents have
private physicians, they have questions         0
                                                     2006      2007           2008           2009   2010
about their medications, diet or even       # Seen    145       147            145            140    90
when to contact their doctors.



Health Education:
                                                               The Cudahy Health Department has a
                                                               statutory obligation to educate the general
                                                               public about emerging or current health
                                                               issues. One of the best and most eye-
                                                               catching ways of informing our residents
                                                               about health topics is with display boards that
                                                               are normally found in City Hall hallways.

                                                               In addition to the display boards, Health
                                                               Department staff author articles for the City
                                                               newsletter which is delivered to every Cudahy
                                                               household twice yearly. Health information is
                                                               also posted on the City’s website at
                                                               www.cudahy-wi.gov.

                                                                 In 2010, Cudahy Health Department staff
conducted 13 classes for 185 individuals. Topics for these classes included communicable disease control and
prevention, wellness and health promotion as well as emergency preparedness.
2010 Flood:
               It seems that no year would be complete without
               some sort of disaster and this year it occurred on
               July 22 & July 23, 2010. This flooding resulted in
               a federal disaster declaration.

               The Cudahy Health Officer donned her “other
               hat” as Emergency Management Coordinator and
               worked with the Mayor, City Department and
               FEMA to assess municipal damages and apply for
               financial assistance.




              85+ Cudahy households were impacted by the July
              2010 flooding with an estimated $164,000 in
              losses. A total of 63,640 pounds of flood debris
              were picked up and disposed of by the Cudahy
              DPW.

              For more than a week after the flood, Cudahy
              Health Department helped to distribute flood
              clean-up kits that were obtained from the
              Salvation Army at City Hall as well as at the Fire
              Stations. In addition, staff provided instruction to
              residents on proper clean-up of flood water and
              sewage. In all, the Health Department staff
              devoted 55.85 hours to this effort.
Sharps Disposal:
                                                                                            Sharps Collection


                                                               500
                                                                                                                       470
                                                               450
                                                                                                                              441

The Health Department continues to dispose                     400
                                                                                                                403

of household sharps and syringes for Cudahy                    350

residents only. Our Department has been                        300
                                                                                   291
                                                                                            312


designated as a “Drop Off Site” by the                         250       230
Wisconsin Department of Natural Resources.                     200




Sharps are only accepted in DNR-approved                       150




containers during normal Health Department                     100




hours. They are sent for incineration with                      50



the Health Department’s needles and                              0
                                                                         2005      2006     2007                2008   2009   2010

syringes on a monthly basis.

Cudahy/St. Francis Hospital Lending Service:
                                                                                       The Cudahy Health
                            Cudahy/St. Francis Kiwanis Hospital Lending Service
                                                                                       Department has been
        200                                                                            administering this
                                                                                       Hospital Lending
        180

        160

        140
                                                                                       Service for the
        120

        100                                                                            Cudahy/St. Francis
         80

         60
                                                                                       Kiwanis since the
         40                                                                            1950’s. This service
                                                                                       lends a variety of
         20

          0


      New
                 2006
                  194
                              2007
                               172
                                           2008
                                            133
                                                         2009
                                                          146
                                                                     2010
                                                                      121              hospital equipment
      Renewed     46           41           17            29          20               such as wheelchairs,
                                                                                       commodes and
walkers to Cudahy and St. Francis residents on a short term basis. The Kiwanis maintain the equipment which
is occasionally donated by Cudahy residents.

Delivering Fire Prevention:
                                                                           The Cudahy Health Department, in collaboration with
                                                                           the Cudahy Fire Department, Safe Kids of Southeastern
                                                                           Wisconsin and the South Milwaukee Pizza Hut has been
                                                                           participating in this event for a number of years.

                                                                           On a specific day in October which is National Fire
                                                                           Prevention month, Cudahy families who order a pizza
                                                                           from Pizza Hut receive a visit from Cudahy firefighters
                                                                           in a fire truck. The firefighters teach the family about
                                                                           fire safety and evacuation plans. If the family’s smoke
                                                                           detector is in working order, the family’s pizza is free.
Environmental Health:
For over ten years, the Cudahy Health Department has been a member of
the Environmental Health Consortium with the Health Departments of South
Milwaukee and St. Francis. The Consortium members share one full-time
and one part-time Environmental Health Specialists who are Registered
Sanitarians. In addition to inspecting and licensing a variety of food
establishments, rooming houses and investigating other environmental
health complaints, the Environmental Health Specialist also oversees the
Cudahy Weights and Measures program.

In 2010 our Environmental Health Specialist:

      Did 232 food-related inspections
      Assured that 38 animals that bit were properly quarantined and evaluated for rabies prevention
      Oversaw the application of over 5600 larvicide packets in Cudahy catch basins
      Investigated one home of a child with lead poisoning
      Inspected 15 farmer’s market and/or temporary events
      Inspected 25 scales in Cudahy businesses
      Tested 63 timing devices in City Laundromats
      Inspected 181 gasoline pumps at Cudahy gas stations. All pumps passed measured correctly.
      Verified that 22 scanners in Cudahy businesses were scanning correctly.

2010 Block Grants:
Grants:                  Grant Funds for         All Consortium      2009 Roll-Over          Total Grant
                         Cudahy Health         Grants Managed by         Funds            Funding Managed
                           Dept. Only            Cudahy Health                            by Cudahy Health
                                                      Dept.                                  Department
    Public Health            $26,332                                                           $26,332
    Preparedness
Children with Special        $3,437                                                             $3,437
 Health Care Needs
  Cities Readiness           $6,313                                                             $6,313
       Initiative
 Early Detection &            $501                  $1,598                                      $2,099
     Diagnosis of
      Pregnancy
         H1N1                $53,997                                                           $53,997
Immunization Action           $9,096                                     $1,582                $10,678
         Plan
   Lead Poisoning            $5,018                 $1,405                $713                  $7,136
      Prevention
  Maternal & Child           $10,966                                     $1,228                $12,194
        Health
  PH Preparedness                                  $287,681                                   $287,681
     Consortium
      Prevention             $5,325                                      $1,527                 $6,852
        Radon                $3,000                                      $1,617                 $5,117
         WIC                $446,972                                                           $446,972
         ARRA                $6,772                                                             $6,772
   DOT Car Seats             $4,000                                                             $4,000
                TOTAL:     $588,229                $290,684              $6,667               $875,580
Public Health Preparedness Grants:

Cudahy Health Department participated in a number of public health preparedness grants in 2010: Cities
Readiness Initiative (CRI), Public Health Emergency Preparedness (PHEP), American Recovery and
Reinvestment Act (ARRA), H1N1 and acted as the Fiscal Agent for the Milwaukee/Waukesha County
Consortium for Emergency Public Health Preparedness.

Each of these grant programs have specific negotiated objectives and activities. For example, the CRI grant
has objectives that relate to identifying and opening mass clinics for medication and vaccine delivery. As a
direct result of the H1N1 clinic that was held at the Cudahy High School in 2009, the Health Department has
now identified new mass clinic site. The PHEP grant focuses on general areas of public health preparedness
using an all-hazards approach with training on use of personal protective equipment, applications of NIMS
(National Incident Management System), etc. ARRA and H1N1 grants dealt specifically with the investigation,
control and vaccine administration related to the H1N1 outbreak.

The larger PHEP Consortium grant afforded a number of trainings such as MAC (Multiple Agency Coordination)
and Zoonotic and Vector-Borne Diseases, media relations and use of communication equipment such as
satellite phones, HAM radios and 800 MHz radios. In addition the PHEP Consortium looked at special needs
populations and their needs in an emergency. As a result of this project, the Cudahy Health Officer, a Cudahy
PHN and a member of the Cudahy Fire Department began working with two senior housing complexes that
had no written all-hazards emergency plans. A Homeland Security grant application was filed to allow resident
education and actual drills with the residents.

In 2010, Cudahy Health Department staff spent 694.65 hours on preparedness activities which included the
final report of the 2009 Patrick Cudahy fire as well activities related to the 2010 flood.

Early Intervention & Diagnosis of Pregnancy (EIDP):

The EIDP grant is a consortium grant with the Health Departments of Greendale,
Greenfield and South Milwaukee with the Cudahy Health Department acting as the
fiscal agent for this grant. During 2010, 17 women were provided services
through this grant. 11 women confirmed their pregnancy and were referred to the
appropriate health department for further public health nursing follow-up, WIC and
healthcare providers.

The Cudahy Health Department was informed that this grant will not be available to
local health departments in 2011. Cudahy Health Department will continue to
provide pregnancy screening and referrals to Cudahy clients only.

Immunization Action Plan (IAP):

The IAP grant is a consortium grant with the Health Departments of Cudahy and
Greenfield. The purpose of this grant is to raise immunization rates within these two
communities. In 2009, the immunization rate of Cudahy children who were 24 months
of age was only 64%. In 2010 the Cudahy Health Department planned to increase this
number to 69%. Cudahy children obtain their vaccinations from a number of places
including their physicians and their local health department. The Health Department
sent postcards to all Cudahy children who were overdue for their immunizations as well
as working with the Cudahy WIC Project. By the end of 2010, 70% of Cudahy children
who were 24 months of age were up-to-date on their immunizations.
Lead Poisoning Prevention:

With almost 63% of Cudahy housing build prior to 1955, blood lead
poisoning in children is a concern for the Health Department. The
Health Department functioned as the fiscal agent for a Lead Poisoning
Prevention Consortium with Franklin, Greenfield and South Milwaukee.

The grant worked with the Cudahy WIC Project to screen appropriate
children for blood lead poisoning during their WIC appointment. In 2010,
89 Cudahy children, 26 Franklin children, 56 Greenfield children and 58
South Milwaukee children were screened. Of those children, 4 had
elevated blood lead levels. The Health Department also followed 9
Cudahy children with elevated leads.

Another lead grant objective was to provide Lead Safe classes for Cudahy home owners and contractors. 7
individuals attended the class that was taught by Milwaukee Lead & Asbestos Information Center.

The final objective was to identify families who live in homes built prior to 1955 and offer simple lead cleaning
techniques to prevent children from becoming blood lead poisoned. In 2010, 5 Cudahy families agreed to
participate. The presence of lead was identified through wipe sampling in each of these homes. After testing
either appropriate cleaning or in one case, window replacement decreased the possibility of lead poisoning.

Maternal & Child Health (MCH):

                        The MCH objective continues to center around assuring that Cudahy children as well as
                        children attending the Cudahy WIC Project are properly placed in a child passenger
                        safety seat. The Cudahy Grant Coordinator is certified as a Child Passenger Safety
                        Seat Technician through Safe Kids of Southeast Wisconsin Coalition.

                        During 2010, our Grant Coordinator inspected 230 child passenger safety seats. 80 car
                        seats were destroyed because they were old or damaged or recalled. 93 new car seats
                        were provided to parents. Some of these seats were obtained through a DOT grant.
                        Only 5 child passenger safety seats were used correctly and installed in vehicles
                        properly.



Radon:

Radon is a cancer-causing radioactive gas that cannot be seen, smelled
or tasted. It is the second leading of cancer in the US and claims
about 20,000 lives annually. In 2010, the Health Department
distributed 111 radon test kits to City residents. 46 of those tests were
completed with 13 households demonstrating an elevated radon
measurement. Those homeowners were contacted about how to
mitigate the elevated radon levels.

In addition there were two classes held for local realtors on radon
testing. This grant will not be available in 2011.

Prevention:
The Cudahy Health Department partnered with the Cudahy Police Department at the Cudahy National Night
Out on August 5, 2010 to hold a bicycle helmet fitting event.

This event not only met one of the Department’s Prevention Block Grant objectives but it also met one of the
needs identified during the last Cudahy Health Assessment. Only 33% of our residents use helmets when
biking or skating. Our Grant Coordinator, Ed Wrench and one of our summer employees, Kyle Martel to help
meet those needs by giving out 200 free bicycle helmets to children aged 3 years and older. Each helmet was
properly sized and fitted to the child. Parents were instructed on how to properly fit and use the helmet.
Bicycle safety information was also shared.

In addition, the Grant Coordinator worked with the five elementary schools in the Cudahy School District to
instruct students on pedestrian safety. On October 6, 2010, each school had a walk to school practicing the
safety lessons that they had learned. In all there were 247 participants – 173 children, 32 teachers, 58
parents, 1 Safe Kids Coalition member and 1 alderman.

Children & Youth With Special Health Care Needs (CYSHCN):

The CYSHCN grant is provided through Children’s Hospital of Wisconsin to provide referrals, follow-up and care
coordination when necessary for Cudahy children who have special health needs. 13 children were offered
services involving multiple agencies. This grant will not be available in 2011.

WIC (Women, Infants & Children Project:

The Cudahy Health Department
has been the fiscal agent for the                            Cudahy WIC Project Recipients
Cudahy WIC Project since 2006.
                                           3500

WIC provides nutrition and
                                           3000
breast-feeding services for
families who qualify financially.          2500
As illustrated, the WIC caseload
continues to grow.                         2000



The WIC Breast-Feeding                     1500

Coordinator and the Peer Breast-
Feeding Counselor both just                1000

received their IBCLC
                                            500
(International Board Certified
Lactation Consultant)                         0
certifications. These two staff                    2006        2007         2008             2009   2010
                                        Women      1134        1243         1313             1448   1345
members will enhance breast-            Children   2498        2634         2887             3351   3429
feeding education for our WIC
clients.



School District of Cudahy Nursing:

October 25, 2010, the School District of Cudahy and the Cudahy Health Department entered into an
agreement “to provide cost effective school nursing services to the School District of Cudahy as well as further
the collaborative relationship that is mutually beneficial to both entities.” What this means is that a Cudahy
Public Health Nurse (PHN) will work approximately 15 hours/week during the school year to provide health
education and coordinate necessary services that will benefit the School District’s students with special health
care needs. In return, the School District will reimburse the Health Department for the PHN’s time in the
schools.

This collaboration is a positive solution to meet both the needs of the School District of Cudahy and of the
Cudahy Health Department.

				
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