HomeMy WebLinkAboutbocc.packet.05272014.Board of HealthAGENDA ITEM SUMMARY
SPECIAL MEETING DATE: May 27, 2014
AGENDA ITEM TITLE: Public and Environmental Health Quarterly Update with
the Board of Health
STAFF RESPONSIBLE: Nan Sundeen, Liz Stark
ISSUE STATEMENT:
This is the second quarter update for 2014 between the Board of Health, Community Health
Services, Inc. (CHS), Pitkin County Local Medical Officer, Pitkin County Environmental Public
Health Advocate and Pitkin County Environmental Health.
BACKGROUND:
The Board of County Commissioners (BOCC) serves as the Board of Health (BOH) for Pitkin
County. Quarterly, Liz Stark, Pitkin County Public Health Director, presents updates, issues,
policies and concerns for Board of Health input and review. Today, she will present updates on
the Core Public Health Services, Aspen to Parachute Dental Alliance, HB14-1288 — Student
immunizations prior to school attendance and the Fatality Review Team. In addition, Kurt Dahl,
Environmental Health Manager and Tom Dunlop, Environmental Public Health Advocate will
review their updates. The Local Medical Officer, Dr. Kimberly Levin, will present an update on
suicide.
In September 2013, City of Aspen, Pitkin County and Community Health Services staff
participated in a joint City/County Board of Health meeting and received general approval to
move forward with the concept of dismantling the City of Aspen Board of Health in order to
establish one Pitkin County Board of Health. Staff expected the City of Aspen to take this action
in mid -March; however, we have run into a snag that will delay this action. The Colorado
Department of Public Health and Environment (CDPHE) has asked the City and County
Environmental Health Departments to combine their Consumer Protection programs. This does
not mean a program merger. Instead, they simply want to have one contract with our Public
Health Agency and then we can divide up the money as appropriate.
This new expectation from CDPHE will require an Intergovernmental Agreement (IGA) to
protect the City of Aspen's funding for their Consumer Protection program. Staff is currently
working on a draft an IGA to present to the Board of County Commissioners and City Council
by the end of July. After the IGA is approved the Pitkin County Board of Health can be
expanded with one new member from City of Aspen and one from the Town of Snowmass
Village (2 total). Staff assumes that the BOH will solicit recommendations from the City of
Aspen and Town of Snowmass Village for the BOH. Once the Pitkin BOH approves the two
nominations, staff will draft a resolution establishing the Pitkin County Board of Health with
seven members.
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Staff is currently working to organize a joint Board of Health/ Community Health Services board
meeting in July. The goals of this meeting include building the relationship between the two
boards and to align the strategic direction for public health.
LINK TO STRATEGIC PLAN:
Livable and Supportive Community- Self Sufficient Individuals and Families
Prosperous Economy — Affordable and quality health care options
KEY DISCUSSION ITEMS
1. Review the updates presented by Liz Stark, Pitkin County Public Health Officer.
2. Review the updates presented by Kurt Dahl, Environmental Health Officer, Tom Dunlop,
Environmental Public Health Advocate and Dr. Kimberly Levin, Local Medical Officer.
3. Provide any thoughts or direction regarding the joint Board of Health/Community Health
Services strategic planning session in July.
BUDGETARY IMPACT: None at this time.
RECOMMENDED BOH ACTION: None at this time
ATTACHMENTS:
A) Memo from Public Health Director, Liz Stark
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ACOMMUNITY
j HEALTH SERVICES"=_
0405 Castle Creek Rd., Suite 6. Aspen, CO 81611, Phone: (970) 920-5420. FAX: (970) 920-5419
ATTACHMENT A
To: Pitkin County Board of Health
From: Liz Stark RN, Pitkin County Public Health Director; Director, Community Health
Services, Inc.; Kurt Dahl, Pitkin County Environmental Health Manager; Dr.
Kimberly Levin, Pitkin County Medical Officer; Tom Dunlop, Pitkin County
Environmental Public Health Advocate,
Date: May 21, 2014
Re: Quarterly Board of Health meeting on May 27th, 2014
COMMUNITY HEALTH SERVICES QUARTERLY UPDATE:
Submitted by Liz Stark
This quarterly report is organized to provide program updates as they relate to the Core Public
Health Services. As a reminder, below is a list of the Core Public Health Services which were
put into rule in 2011 and were required at part of the Public Health Act of 2008.
1. ASSESSMENT, PLANNING, AND COMMUNICATION;
2. COMMUNICABLE DISEASE PREVENTION, INVESTIGATION, AND CONTROL;
3. PREVENTION AND POPULATION HEALTH PROMOTION;
4. EMERGENCY PREPAREDNESS AND RESPONSE;
5. ADMINISTRATION AND GOVERNANCE;
6. ENVIRONMENTAL HEALTH.
Core Public Health Services:
Assessment and Planning: Public Health Priorities identified in Community Health Assessment:
Addressing the Needs of a Growing Older Adult Population Update:
• Public Health has been participating on the Project Management Team and Steering
Committee for the Aging Well Community -wide Strategic Planning Initiative for Older
Adults in Pitkin County.
• Next Steps: Aging Well Summit — June 24, 2014.
Mental Health and Substance Abuse Prevention and Treatment Priority Update
• Public Health is partnering with a local physician to research and promote a screening
tool and referral system for primary care practices.
• Public Health has participated in planning a Community Forum on Mental Health,
spearheaded by the Aspen Hope Center.
• Public Health participates in the Valley Marijuana Council, and has helped to plan 3
community forums about recreational marijuana use and develop measures and protocols
for monitoring the introduction of recreational marijuana in the community.
• Next Steps: Convene a group to work on a comprehensive community prevention plan for
Mental Health and Substance abuse in the fall of 2014.
Pathways to Health Priority Update:
• The Mid -Valley Access to Care Task Force has been working to update service listings
on 211. Over 40 individuals attended a training on how to update their 211 profile in
September 2013.
• Public Health has worked to share the results of a local BRFSS survey in the Mid -Valley
region with partners in order to increase understanding about the needs of the population
in this area.
• Public Health participates in the West Mountain Regional Health Alliance, and through
this group applied for regional funding to provide health coverage guides throughout the
region.
• Public Health participated in a meeting with local practitioners who are working towards
a medical neighborhood model.
• Next Steps: The Mid -Valley group will hold a strategic planning session May 5th, and a
211 promotion campaign will be planned.
Radon Awareness and Mitigation Update:
• In partnership with Garfield County Environmental Health, the City of Aspen
Environmental Health department held a DIY (do-it-yourself) radon mitigation class in
Carbondale on May 17th, 2014. 13 people from Aspen to Parachute attended the class.
• Next Steps: Pitkin County and City of Aspen Environmental Health staff will be attending
radon testing and mitigation training to increase staff capacity for understanding the most
up -to date testing and mitigation techniques.
Strengthen Internal Capacity Update:
• A new medical officer was hired in the summer of 2013according to newly developed
guidelines.
• A Public Health Planner oversees the implementation of the PHIP and alignment with
community partners.
• Next Steps: A CHS Board strategic planning session is planned for May 29, 2014.
Communicable Disease Surveillance and Investigation:
• A recent Tuberculosis investigation resulted in 6 cases of latent tuberculosis which CHS
will be managing for the next 6-9 months.
• In April, CHS participated in a project led by Colorado Department of Public Health and
Environment, the Colorado School of Public Health and the Colorado Association for
Local Public Health Officials (CALPHO). The goal of the project is to measure the
variable and fixed estimated costs of delivering Colorado's core public health services.
Though the Core Services were established in 2011, several of them remain unfunded or
underfunded. Communicable Disease investigation and surveillance is the first core
public health service to be evaluated. During that two week period, nursing staff
performed time studies and completed surveys.
• Since January of this year, CHS has investigated 10 reportable illnesses. They include:
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3 pertussis/whooping cough
- 1 Campylobacter
1 Typhoid fever
- 2 Salmonella
2 Cryptosporidiosis
- 1 E-coli/STEC 0157
Prevention and Population Health Promotion:
• CHS continues to operate all of its direct service programs which address the
requirements of this core service. Family Planning/Women's' Health, immunizations,
prenatal, and WIC (Women, Infant and Children nutrition program) all contribute to the
health status of infants, children, youth, women and their families.
• CHS is embarking on a monthly health promotion campaign where we will feature a
program and the importance of a particular health topic related to that program.
Emergency Preparedness and Response:
• Liz participated in the County sponsored Mass Care Training on April loth. Also in attendance
were other local ESF8 partners, Aspen Valley Hospital and the Ambulance service as well as
many other Pitkin County ESF team members. It was particularly valuable to learn how ESF 8
and ESF 6 work together to respond to the human needs during a disaster.
• ESF (Emergency Support Function) 8 — Public Health and Medical will be meeting at the end of
the month to review each agencies Hazard Vulnerability Plan and identifying ESF8 specific
priorities within each plan.
Administration and Governance:
• CHS is partnering with Eagle County on a regional Public Health Planner position for the
Pitkin and western Eagle County. This position is partially funded by Eagle County. This
person is responsible for coordinating public health initiatives and partnerships in the
region. Our current Public Health Planner, Jordana Sabella, assumed this role on April 1,
2014. Jordana is out on maternity leave until August so I will be the point person in her
absence.
• A joint strategic prioritization meeting between the CHS Board of Directors and the
Board of Health is planned for July 22nd from 3-5. The goal was to have the new Board of
Health members seated prior to this meeting but this may not be possible.
Child Fatality Review Team Update:
At our 2013 3rd quarter update, I provided information about new legislation that establishes
local Child Fatality Review Teams. This legislation puts Local Public Health Agencies in charge
of establishing the local teams. On May 1, 2014, CHS hosted the first local Child Fatality
Review Team training. Mandatory team members include:
1. County Department of Social Services
2. Local Law Enforcement
3. The District Attorney's Office
4. School Districts
5. Local Public Health Agency
6. Coroner's office or county medical examiner
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7. County attorney's office
We had representation from all the mandatory member agencies and several from other
recommended agencies such as:
1. Hospitals - Aspen Valley Hospital
2. Mental health professionals- Mind Springs Health
3. Child Advocacy agencies- Kids First and the Buddy Program
As the coordinator for this team, I will be attending a two day training in Denver on June 4th and
5th. The team plans to convene in August to establish its administrative processes and review any
child fatalities that have occurred in 2014.
Aspen To Parachute Dental Health Alliance Update:
The Aspen to Parachute Dental Health Alliance (APDHA) continues to focus on promoting
education, prevention and access to oral health for the residents from Aspen to Parachute.
Program activity includes `Smiles for Seniors' and' Smiles for Students'. The senior program is
a collaboration with Pitkin County Senior Services and provides 4 preventive clinics a year in
several locations in the valley. At these clinics, dental hygienists provide basic preventive exams
and make referrals for those seniors who need treatment services.
The Smiles for Students program provides the same preventive hygiene services to children in
schools throughout the region, including Garfield, Pitkin and Eagle County schools.
The APDHA is now partnering with Eagle County through a grant obtained from them to
provide the school dental program in Eagle County schools. 138 children from elementary
schools in Gypsum and Edwards received this service in April.
Cavity Free at Three trainings continue with dental offices, the next one taking place Edwards in
June.
The Alliance is planning an Oral Health Summit in September 2014 as a follow up to the Cavity
Free at Three Kick -Off that took place two years ago. The emphasis of this year's summit will be
a celebration of the progress that has been made in addressing oral health in the region over the
last few years and to identify gaps in services that now exist due to Medicaid expansion and the
Affordable Care Act. Please keep an eye out for a Save the Date invitation in the next month or
so.
New Immunization legislation-HB 14-1288 — Immunizations for students upon entering
school:
House Bill 14-1288, introduced by Senator Aguilar and Rep. Pabon, passed during this
legislative session. The controversial immunization bill changed significantly from the original
one submitted. Originally, it would have required that parents who wanted to use the personal
belief exemption to either be briefed by a health care professional on the pros and cons of
immunizations or complete an online education module. This provision created lots of
controversy among both anti -vaccine groups and vaccine supporters.
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Instead, the bill creates several duties for the Colorado Department of Public Health and
Environment, including:
• Creation of a website containing information about the benefits and risk of immunizations;
• Issuance of rules on how often child care centers and schools should collect exemption forms;
• Working with other state agencies to develop a common policy on immunization data
collection;
• Providing technical assistance to child care centers and schools on how to analyze
immunization data;
• Requires schools to make available on request their immunization and exemption rates.
Two years ago, the CDC listed Colorado as having the second -highest rate of vaccine
exemptions in the country. Colorado allows three kinds of vaccine exemptions: religious,
medical and those tied to personal beliefs. Last year, the personal belief exemption, which only
requires a parent's signature, made up 93 percent of the estimated 2,869 opt -outs granted to
Colorado kindergarteners. High exemption rates are a concern for public health officials because
the greater the unvaccinated population, the higher the likelihood that preventable diseases will
be able to spread and possibly find their way to newborns and people with compromised immune
systems, where the results could be fatal.
Aspen School District reports an exemption rate of approximately 10%. They have an overall
immunization compliancy rate of 99% which includes those with person belief exemptions. The
Colorado Department of Public Health and Environment currently does not have a mechanism to
measure county level rates for comparison purposes. This new reporting requirements of schools
may make it easier for CDPHE to provide comparative data that is useful for determining how
we are doing locally and what improvement strategies should be implemented.
ENVIRONMENTAL HEALTH QUARTERLY UPDATE:
Submitted by Kurt Dahl — Pitkin County Environmental Health Manager
Air Quality:
Truck Opacity Check — In June we are going to assist Aspen Environmental Health with
checking commercial trucks entering Aspen. We will be doing a visual check on the exhaust
from trucks entering the city for compliance with the State of Colorado's Air Quality
Regulations.
Consumer Protection Program:
Inspections and license renewals — The department has completed 60% of the required inspection
for the consumer protection contract. 100 of 101 (99%) facilities have paid for their 2014 REF
license renewal.
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Fees bill — In the previous memo I discussed CCI having interest in developing a bill to
change/increase the retail food establishment fees. CCI has been working with the Restaurant
Association and a possible bill has been discussed but it will be delayed until the next session to
allow for some additional work over the summer
Contract with CDPHE — The State has asked EH and the Aspen Environmental Health
Department if we will combine our contracts for consumer protection into one contract.
Currently we have separate contracts with CDPHE and they would like for us to combine our
contracts to streamline their process. Neither agency would lose revenue if we agree to a single
contract with the State. Discussions are ongoing.
Onsite Wastewater Treatment System (OWTS) Program:
New Construction permits- We have issued 21 new construction/repair permits to date. The same
time last year we issued 14 new construction/repair permits (150% increase). This is consistent
with the increase in building activity and permits the building department is seeing.
Use Permits — We have issued 21 use permits to date. The same time last year we issued 19 use
permits (111% increase).
New Pitkin County OWTS Regulations- The draft OWTS regulations have been sent to the State
Health Department for their initial review. Once we have their approval, we will have a formal
BOH meeting to discuss and approve the draft. We have also scheduled a contractor meeting on
June 4th to discuss the draft regulations and get additional feedback.
Gray Water — The State Health Department has temporarily suspended the regulation
development. There are several issues that need to be addressed but the reason for the delay is
that the State Plumbing Code does not allow for gray water reuse and before moving forward
with our regulations, the State Plumbing Code must be changed. The length of the delay is
unknown at this time and mostly depends on when the plumbing code can be changed.
Disease Control:
Hantavirus — In April, Garfield County reported the first case of Hantavirus in Colorado in 2014.
With the warm weather we expect people to be cleaning out of garages, shed, and barns. Please
be aware and take precaution to avoid exposure. More information and recommendations on
proper cleanup procedures can be found at:
http://www.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername 1=Content-
Disposition&blobheadername2=Content-
Type&blobheadervalue 1=inline%3B+filename%3D%22Hantavirus+Prevention+and+Cleanup+
Guidance.pdf%22&blobheadervalue2=application%2Fpdf&blobkey _id&blobtable=MungoBlobs
&blobwhere=1251811847110&ssbinary=true
Rabies Vaccination Bill — A bill has been sent to the Governor's desk for signature requiring
proof of rabies vaccination at registration of cats and ferrets. Currently statute requires only dogs
have a current rabies vaccination when they are licensed. There has been an effort to require the
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vaccination of cats and ferrets for several years because if they are not vaccinated, they can pose
a risk to the public if they have been exposed to rabies through other animals or hunting.
Hazardous Materials:
OSHA 8-hour update and asbestos response — Tom and I recently attended an 8-hour OSHA
refresher. The refresher training came into use two weeks later when I assisted with the County's
asbestos spill response. I worked with the abatement contractor to remove and clean potentially
contaminated equipment for the Clerk and Recorder and provided security for Elections when
their closet in the basement was "cleaned".
ENVIRONMENTAL PUBLIC HEALTH ADVOCATE QUARTERLY UPDATE:
Submitted by Tom Dunlop
CDC Food Safety Modernization Act
Background:
As I presented to you at the October 2011 BOH meeting, I have accepted an appointment by the
Centers for Disease Control and Prevention (CDC) to represent the National Environmental
Health Association on a committee to help design the national response to the Act of Congress
mentioned above. I am a member of the Food Safety Modernization Act (FSMA) Surveillance
Working Group of the Office of Infectious Diseases, CDC Board of Scientific Counselors. This
appointment extends from July 1, 2011 through June 30, 2014.
President Obama signed FSMA into law January 4, 2011. The intent of the law is to refocus
efforts of regulators from reacting to food borne illness to prevention of food borne illness. Go
to www.fda/fsma.gov for more information. This represents a significant step from being
reactive to being proactive in food safety.
During the first meetings of the FSMA work group the design and selection of specific academic
Centers of Excellence was completed. Five academic Centers were chosen (FL, CO, TN, MN,
OR) to address issues critical to protection of the food supply in the United States. Academic
coordination, workforce development, communications, performance metrics and research are
the challenges assigned to the Centers.
Status update:
Our first 2014 meeting was held May 5-6 in Atlanta, GA at CDC headquarters. The focus of this
meeting was the surging presence in the world of antimicrobial resistant organisms. The threat to
the United States food supply is becoming of great concern to the scientific community and
producers of food. The National Antimicrobial Monitoring System (NARMS) is at the forefront
of keeping tabs on this threat. Go to www.cdc.gov/narms to see why this concern is such a high
priority in protecting our food supply and the health of consumers. The routine, and sometimes
excessive, use of antibiotics in animals; the emerging market of organic food with no antibiotic
pretreatment; and combinations of the two offer important discussions.
While debate at the CDC meeting was worldly in scope, it is very easy to see how local health
departments are key partners in data gathering to add clarity to the detective work ongoing to
address this problem. Keeping local environmental public health staff up to speed with evolving
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science around microbes that are resistant to traditional antibiotics is critical as "all public health
is local." This latter quote is widely expressed in scientific circles.
My term on this work group expires June 30, 2014. At the May 2014 meeting I was recognized
as one of the members reappointed for another 3-year term, expiring in 2017. There are 17
members of the work group, 6 members rotated off and 6 new members will attend the
December 2014 meeting. I will continue to represent the National Environmental Health
Association.
My appointment as the Pitkin Co. Env. Public Health Advocate has helped me gain standing
with this work group. Although not a charge of the surveillance work group, I took the
opportunity in May to again stress to my federal colleagues how impacting the encompassing
FSMA standards are felt at the county level. It is necessary to remind my colleagues on the work
group about how important organizations such as the Pitkin Co. Environmental Health
Department are to this national debate.
CDC Environmental Public Health Tracking Network (EPHT)
Background:
I have reviewed this program with the BOH in past reports so will not go into a lot of detail. In
summary it is a national surveillance program designed to identify various illness and disease
associated with environmental exposures. Initial focus was pairing environmental exposures to
birth defects, asthma and various forms of cancer.
Colorado is a state funded by this federal program and is housed in the Colorado Dept. of Public
Health and Environment. I sit on the technical advisory committee for this program. This
program identifies linkages between certain illness and disease with environmental exposures
(air and water pollution, land use contaminants and other environmental stressors). I encourage
you to visit the web page www.coepht.org to view county specific data on heart attacks, asthma,
radon, etc.
Status update:
I serve on the National Association of County and City Health Officials EPHT work group.
Recently I was asked to be considered to chair this work group. If selected, this will be my
second term as chair. Membership of this committee includes representatives from local health
departments from various health departments across the United States (ie. Fl, NY, WA, OH, VA,
MN and others).
I remain a member of the Colorado EPHT advisory group even though we have not met for over
3 years. This is still an important program to citizens of Colorado and I will continue to push for
success stories to share with you, Pitkin Co. Env Health Dept, City of Aspen Env Health Dept,
and Community Health Services.
Colorado State University (CSU)
Background:
I continue volunteer duties with the CSU Department of Environmental and Radiological Health
Sciences on their advisory committee. To recap, this position may allow Pitkin Co. an
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opportunity to entertain the option of placement of an Env Health intern from CSU to aid in
special projects. I am also actively engaged in curriculum design for the school.
Status update:
Unfortunately I was unable to attend the spring meeting of this important advisory committee to
the Environmental Health undergraduate program due to scheduling conflicts. I do not have an
update.
Colorado School of Public Health (CSPH)
Background:
I received notice from CSPH that there is interest in me serving in discussions of creation of a
distance learning degree in the existing Masters of Public Health program. As a 2009 graduate of
the Univ of Massachusetts - Amherst MPH program, I have offered to share my UMass
experiences during the formative conversations at the CSPH. A larger outcome I hope to share is
how important a properly educated environmental public health workforce is to local health
departments.
Status update:
Movement towards an online MPH program is slow at CSPH. I am aware of a number of
colleges and universities exploring development of distance learning programs to reach mid -
career environmental public health practitioners. To develop the concept and then transform that
into actual classes is a difficult challenge. I have hope that the CSPH will be successful.
National Association of County and City Health Officials (NACCHO)
Background:
I currently serve on a number of work groups and committees for this national public health
organization. The list includes: Environmental Health Essential Services Committee (of which I
am past Chair), Food Safety Workgroup, and the Environmental Public Health Tracking
Workgroup. I serve in an advisory capacity in policy development for topics such as mosquito
control, hydraulic fracturing, climate change, water quality, environmental justice and healthy
community design.
Status update:
The Food Safety Work Group has had recent discussions of the Food Safety Modernization Act
mentioned above in the CDC section. This work group and NACCHO have been following the
Food and Drug Administration release of the Operational Strategy of FSMA. The emphasis of
this strategy is how "...FSMA will advance public health by focusing on prevention, voluntary
compliance, risk -based oversight and expanded collaboration across the food safety community."
My work on the Environmental Public Health Tracking Work Group is discussed above under
the CDC EPHT section.
A study released May 1, 2014 by Legacy (www.legacyforhealth.org) gave startling statistics on
e-cigarettes. 89% of young people aged 13-29 are aware of e-cigarettes; more than 14% of young
people aged 13-17 have smoked e-cigarettes; more than 39% of young people aged 18-21 have
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smoked e-cigarettes; about 60% of young people aged 13-17 were aware of e-cigarettes
marketing on major advertising channels; a survey of the top 24 e-cigarette brands spent $39
million on advertising between June and November 2013.
The use of these products remains a significant concern to the public health community. The
presence of Acetaldehyde, Benzene, Cadmium, Formaldehyde, Isoprene, Lead, Nichol, Nicotine,
N-Nitrosonornicotine and Toluene and more are enough to raise alarm.
Trust for America's Health released a report on public health funding by state for the period
2012-2013. Colorado ranks 17th by funding $42.85 per capita. Public health funding remains
relatively flat from federal sources while challenges to the public health system continue to
increase. Go to www.healthyamericans.org for a more complete review of these trends.
Colorado Foundation for Public Health and the Environment (CFPHE)
Background:
My volunteer service on this foundation is in its 20th year. I continue to find the challenges of
providing a non-profit organization perspective to the many opportunities to help provide
environmental and public health services to citizens of Colorado rewarding. To view what the
foundation provides please go to www.cfphe.org. Colorado public health and environmental
health organizations have the opportunity to use CFPHE to fund their projects at very low cost.
Status update:
Nothing new to report.
General
I have been sending important web information to Pitkin Co. Env. Health, City of Aspen Env.
Health and Community Health Services. For example; NACCHO, Association of Public Health
Laboratories and the American Association of Poison Control Centers sponsored a webinar on
the 2014 chemical spill into the Elk River in West Virginia. The Roaring Fork Valley has
experienced spills into the Roaring Fork and Crystal rivers in the past. The Elk River spill
reminded us that we are not exempt from having to be prepared for spills in the future.
I sought input from Community Health Services, Pitkin Co. Env. Health and City of Aspen Env
Health while working on revising the NACCHO policy on fluoridation of community water
supplies. This is a politically charged topic in many areas. The position I support is fluoridation
is appropriate from a public health perspective. .
The three local health agencies mentioned above were encouraged to listen to a webinar
sponsored by NACCHO and Menutrinfo on food allergens. This is becoming a significant public
health matter in the United States.
I was published in the Journal of Public Health, Management and Practice May/June 2014;
Volume 20, Number 3. The article I co-authored is titled "Local Perspectives on the
Environmental Public Health Tracking Program." It is a discussion of the value of strong state -
local health department involvement in collecting and analyzing data identifying environmental
exposures and health. The article can be found at www.jphmp.com.
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This concludes this quarterly update. I am always prepared to receive advice from the Board of
Health, Community Health Services, Environmental Health and the Medical Health Officer
should there be an issue of interest.
PITKIN COUNTY MEDICAL OFFICER UPDATE:
Dr. Levin will be providing information about Colorado's suicide rate and local efforts that are
addressing the issue. A copy of her PowerPoint is provided in the memo. There are also two
articles that were placed in your "Read" box for your reference. Those include information
about Mental Health and Substance Abuse as one of Colorado's 10 Winnable Battles and the
other is the Health Behaviors and Conditions chapter from the Colorado Department of Public
Health and Environments' 2013 Health and Environmental Assessment. The entire assessment
is available at www.colorado.gov/cdphe.
Thank you.
Respectfully submitted,
Liz Stark RN BSN
Pitkin County Public Health Director
Director, Community Health Services, Inc.
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Is suicide really a problem in CO?
In 2012, there were.
45 HIV deaths
205 Homicides
457 Motor vehicle deaths
524 Influenza & Pneumonia deaths
585 Breast Cancer Deaths
798 Diabetes deaths
1,053 deaths by Suicide
Suicide is the 7th Leading cause of death in CO for all ages
Sme.:COW°
Colorado Suicide deaths and age adjusted rates,
2008-2012
2008 801 1::0
2009 940 1,3 7
2010 867 16 8
2011 909 174
2012 1,053 19.7
Source. ONO°
Suicide deaths by age and gender, 2008-2012
'__.1' ?J _J 4649 'J J
s.,.e. C0v0n5
Suicide deaths by method and gender, 2008-2012
Females, n.1042
Other
Males, n,3,426
Source. C0M85
1
Total Suicide Deaths, 2007-2011
Colorado Residents, by Health Statistics Region
2011 Healthy Kids CO Survey
Completed by 9th through 12th graders in public high
schools in Colorado
(The data are weighted, and therefore representative}
• 21.9 percent reported feeling so sad or hopeless almost
every day for two weeks or more in a row that they
stopped doing some usual activities during the past 12
months.
• 14.8 percent reported seriously considering attempting
suicide during the past 12 months.
• 6.1 percent attempted suicide one or more times during
the past 12 months.
Picture of the
Roaring Fork Valley
• 2012—none
• 2013 data
— Pitkin — 4 suicides
— Eagle — 3 suicides on this side of the mountain
— Garfield —11 suicides
• 2014
— 5 to date
Aspen Hope Center
• Crisis Intervention #970-925-5858
— Immediate assessment and de-escalation
— Virtual Intensive Outpatient Program (an alternative to inpatient
psychiatric hospitalization)
— Mobile — clinicians will go to the person in need
• Education and Outreach — suicideAwareness Training
Classes — partners with schools, hospitals, businesses, and offers
community classes. Community forums on Mental Health
Mind Springs
(formerly Aspen Counseling Center)
• #970-920-5555
• Individual and Group Therapy
• 24 hour mental health crisis
• Detox Center
• Locations throughout Western Colorado
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