Additional 2007 highlights by program area 

- Clean water
- Complaint responses
- Emergency preparedness and response
- Food safety
- HIV/AIDS
- Infectious disease and clinical programs
- On-site septic systems
- Outreach and education
- Parent and child health
- Solid and hazardous waste
- Tobacco prevention and education
- WIC nutrition

Clean water
Environmental Public Health staff undertook a variety of activities in 2007 to ensure that people in Clark County enjoyed clean water for drinking, cooking, washing, and recreation.

• Inspected more than 300 public pools and spas in Clark County.
• In cooperation with the Washington State Department of Health, trained over 40 operators on how to assure swimming pool safety and water quality.
• Monitored Vancouver Lake swimming areas for E. coli and blue-green algae to assure a safe swimming area for Clark County residents in partnership with the city of Vancouver and Vancouver Clark Parks & Recreation.
• Evaluated 221 individual water wells.
• Audited the decommissioning of 41 abandoned wells for public safety and groundwater protection.
• Conducted 12 sanitary surveys of Group A water systems.
• Conducted 56 Group B water system sanitary surveys.

Complaint responses
Provided education and referrals related to inquiries on a variety of other concerns, including:

• 20 zoonotic (animal) complaints.
• 15 rodent complaints (in addition to the rodent complaints associated with solid waste accumulation).
• 87 mold complaints.
• 23 indoor air complaints.
• 127 dead bird complaints.

Emergency preparedness and response
To improve our capabilities to respond to actual and potential emergencies from natural and human causes, in 2007 Clark County Public Health:

• Responded to numerous disease outbreaks and public health emergencies in Clark County and the surrounding area.
• Provided communities with information about general personal and household preparedness, West Nile virus, pandemic influenza, norvirus, and other actual or potential health threats.
• Increased our outreach to vulnerable populations, including the ability to reach them with public health messages in an emergency.
• Participated in several emergency response exercises to test cooperative emergency response capabilities among local health jurisdictions in Clark, Cowlitz, Wahkiakum, and Skamania counties.
• Developed a communications plan and resource sharing agreement with area hospitals, clinics, and other health care providers as part of the Healthcare Preparedness Coalition.
• Tested a communications system that is interoperable with the systems used by police, firefighters, paramedics and hospitals.
• Worked with other county health departments in our area to develop interoperable communications between public health agencies.
• Conducted a live exercise to test the ability of staff and Medical Reserve Corps volunteers to set up four medication dispensing clinics in Clark County at the same time. Exercises like this better prepare us for the possibility of pandemic influenza or other health emergencies.
• Participated in a full-scale federal terrorism exercise, a county level communications exercise, and a multi-county public information exercise to test different functions that public health will have to perform during a real emergency.
• Conducted risk communication trainings for public health staff and partner agencies to better prepare our workforce to communicate with the public during emergencies.
• Received Board of Health approval to acquire antiviral medications that could be distributed to county residents during a pandemic flu outbreak.
• Participated in a pilot test of a communications system designed to alert all public health staff of an emergency.
• Increased the size of the Southwest Washington Medical Reserve Corps to more than 70 volunteers. Additionally, Clark County Public Health provided four training opportunities to MRC volunteers. MRC volunteers assisted at three community outreach events. In December, the MRC received a formal activation request from Lewis County to provide flood relief and the unit deployed five volunteers to provide assistance.
• Developed a Regional Public Health Emergency Response Team comprising public health staff from several SW Washington health departments who have participated in advanced public health and emergency response training.

Food safety
The food safety program works to protect the public from exposure to disease from foodborne illnesses through regulation of food service establishments and education of food handlers. Clark County has approximately 1,650 food service facilities including school cafeterias, restaurants, coffee shops, delis, taverns, and grocery stores. Food safety specialists conducted routine inspections for each facility from one to three times per year depending on menu complexity. All employees who handle food are required to obtain a food worker card by passing a test on handling food safely. In 2007 the Food Safety Program:

• Conducted more than 4,000 routine, follow-up, and temporary-event food safety inspections.
• Completed 282 new and remodeled food facility plan reviews.
• Responded to 378 food related complaints from the public.
• Conducted 86 foodborne illness complaint investigations.
• Issued more than 13,000 food worker cards.
• Continued partnership with WSU Extension to provide Person-In-Charge Training.
• Partnered with Washington State Department of Health to provide Risk Based Inspection Training for Clark County Food Safety Staff.
• Continued quarterly meetings with the Food Safety Advisory Committee.

HIV/AIDS
In 2007, we provided comprehensive case management services to 280 people living with HIV or AIDS, ensuring that they had access to health insurance, medical care, and other necessary health services. Other activities to treat and prevent the spread of HIV/AIDS in our community included:

• Exchanged more than 370,000 contaminated syringes for sterile ones through our Harm Reduction Center. This intervention has a powerful effect on the prevention of an array of serious infectious diseases, including HIV and Hepatitis, and keeps used injection equipment from being disposed of in ways that endanger the public.
• Provided 176 Hepatitis A and B vaccinations and other health services to participants in community HIV prevention programs.
• Performed 390 HIV tests to persons at high risk for contracting HIV, helping those diagnosed with HIV to access medical care, and working with those who were HIV negative to reduce their risk.
• Partnered with health care providers, social service agencies, and community organizations to develop and implement community education about HIV for health care professionals, agency staff, and the public.
• As the Lead Agency for the Region 6 AIDS Service Network, Clark County Public Health managed an array of coordinated HIV prevention and care services by contracting for $726,000 worth of contracts with 9 local health jurisdictions and 10 service organizations within the 11-county region. Region 6 program staff also gave technical assistance to these services providers and ensured that services were effective and efficient.
• In partnership with a community provider, initiated a new approach to substance abuse treatment that holistically combines HIV prevention with health promotion learning and behavior change for participants in the context of group substance abuse treatment.

Infectious disease
Infectious disease staff responded to multiple reports of disease outbreaks in 2007, including many that required extensive investigation and control. Staff investigated cases and outbreaks of meningococcal disease, avian chlamydiosis, tuberculosis, pertussis, Staphylococcus, suspected mumps, foodborne illness, norovirus, and viral gastroenteritis. In 2007 we:

• Investigated and responded to multiple outbreaks of gastrointestinal illnesses in schools, day care facilities, and residential facilities.
• Received 452 reports from labs and health care providers of acute "notifiable conditions", which are specific diseases that must be reported to Public Health according to Washington law.
• Received 1,144 reports from labs and health care providers of notifiable sexually transmitted diseases.
• Received 5 reports of Hepatitis A disease, 71 reports of Hepatitis B disease, and 133 reports of Hepatitis C infections.
• Provided 1,427 tuberculosis skin tests in the clinic and at community locations.
• Provided 172 refugee health screenings; 507 HIV tests; and 3,380 women's health screenings.

On-site septic systems
Clark County Environmental Public Health helps to protect groundwater by permitting septic systems, overseeing the septic operation and maintenance program, and reviewing land-use plans. In 2007 we:

• Completed a two-year grant-funded survey of onsite sewage systems (OSS) in the Gibbons Creek Watershed to determine sources of contamination.
• Modified procedures and developed new guidelines to comply with new local onsite septic regulations.
• Implemented the OSS Operations and Maintenance program to comply with revised local codes.
• Approved permits for 424 new onsite sewage systems in Clark County.
• Conducted site visits to 347 on-site septic systems.
• Approved 331 on-site septic system reviews.
• Received 398 Public Health evaluation applications for land development.
• Drafted new local on-site septic regulations which were approved as ordinance (CCC 24.17) by the Board of Clark County Commissioners.

Outreach and education
The Outreach Team delivers public health messages to health care providers, community partners, and the general public, and responds to requests for education and outreach. Educational programs with provider clinics, school nurses, extended care facilities and other health care providers focused on:

• Reporting of communicable diseases
• Proper administration of childhood vaccines
• Prevention of viral gastroenteritis
• Prevention of MRSA (methicillin resistant staphylococcal aureau) skin infection
• Proper hand washing
• Low cost health and dental resources in Clark County
• Emergency preparedness
• Reproductive health

In 2007, staff participated in 32 community health fairs and outreach events, focusing mainly on emergency preparedness and West Nile Virus Prevention.

Parent Child Health
In 2007, Parent Child Health served 1,042 clients through home and office visits. We also served 128 clients in parenting classes at the Center for Community Health, and in the Washougal and Battle Ground service centers. Additional 2007 activities include:

• Nurse Family Partnership was implemented in August, 2007. Four home visiting nurses, an office assistant, and a nurse manager were hired and trained in the program principles and curriculum. At the year's end, 26 first-time pregnant women were enrolled in the program. These women will receive visits until their first child's second birthday. When the program reaches capacity in 2008, 100 families will be enrolled in this program.
• Our child care consultants (nurses) provided trainings for child care directors and staff on subjects such as managing food allergies in the child care setting and what to do about MRSA. Staff also served eighteen child care centers with monthly nurse consultations in their infant and toddler areas.
• Staff produced 128 passports (health records for children in foster care) so that the foster parents and medical providers would have accurate health histories.
• More than 10,000 Clark County children have been enrolled in the Access to Baby and Child Dentistry program, which provides preventive and restorative dental care to low-income children 0-5 years of age who might otherwise not have access to dental services. Our oral health staff enrolled and trained 49 local dentists to provide these services.
• A coalition of partners coordinated a Free Dental Day for children to age 19. Partners included: Clark County Public Health, Clark County Dental Society, Free Clinic of Southwest Washington, Greater Southwest Washington Dental Hygiene Association, Ronald McDonald House Charities, Washington Oral Health Foundation, Clark College dental hygiene students, Skill Center dental assisting students, EOCF/Head Start, and OHSU dental students. They provided care to 287 children from ages 0-19. Almost $100,000 of free care was provided that day to residents of Clark County.
• In June, Clark County Public Health staff, Free Clinic staff, and local dentists went to Dobbins Farm to provide dental services to migrant workers. They treated 24 clients with a value of $5,190 of dental care.

Solid and hazardous waste
Improper waste disposal can affect human health and the environment, including important sources of drinking water. In 2007, Environmental Public Health took these steps to reduce environmental contamination from improper waste disposal:

• Solid Waste Handling Compliance
  • Conducted 38 permitted solid waste handling facility inspections.
  • Investigated 180 citizen complaints related to garbage, illegal dumping, and other solid waste issues.
  • Participated in 10 Solid Waste Advisory Commission meetings.
• Hazardous Waste Program
  Clark County Public health works with the Washington State Department of Ecology to investigate sites suspected of contamination with hazardous and toxic materials, including illegal methamphetamine drug labs. In 2007 we:
  • Investigated 39 sites in response to citizen complaints about alleged releases of hazardous materials. Six sites with confirmed contamination were assessed and referred to the Department of Ecology for cleanup oversight. Eight contaminated sites were entered into the Voluntary Cleanup Program under which the owner agrees to pursue cleanup.
  • Investigated three illegal drug labs and denied access to the properties until remediation was complete.
  • Released three residential structures that housed drug labs for reuse after decontamination.
  • Met regularly with local and state agencies to address hazardous waste issues throughout Clark County.

Tobacco prevention and education

• Developed tobacco cessation support for clients of drug and alcohol treatment programs at the Clark County Center for Community Health. Support includes training staff on nicotine dependence, developing a nicotine-free work culture, and nicotine replacement therapy.
• Developed signage and implementation plan for becoming a tobacco-free campus at the Clark County Center for Community Health.
• Partnered with the American Lung Association of Oregon and Multnomah County Health Department on the Portland-Vancouver Smokefree Housing Project, advocating for no-smoking policies at rental properties. Conducted a survey of 465 residents living in Vancouver Housing Authority buildings to assess their desire for smokefree air. Presented survey findings to the VHA board, which then voted to develop a policy of its buildings.
• At the National Conference on Tobacco or Health in Minneapolis, presented procedures and results of a survey conducted to gauge renters' experiences with secondhand smoke intrusion into their apartments

WIC program
Families enrolled in the Women, Infants, and Children Nutrition, Education and Supplemental Food Program (WIC) receive nutrition education, community referrals and coupons for healthy foods choices. In 2007:

• 15,009 women, infants and children were served through the WIC Program.
• $5,403,294 worth of WIC food dollars supported community families while contributing to our local economy through purchases at area grocery stores.
• During summer months, more than $38,960 was spent at the farmers markets in Vancouver and Battle Ground, ensuring families had improved access to local fresh fruits and vegetables.
• WIC referrals to community services and other resources in Clark County totaled 90,117.