PH Matters
In This Issue
Program Links
Service Excellence
You're a Gem for Going the Extra Mile

Dawn Dailey, PHN
Public Health
For her dedicated and vitally important community service to all Californians touched by SIDS. For her invaluable contributions and outstanding performance as a member of the California SIDS Advisory Council.
-Nominated by Thomas Keens, MD, Chair, California Sudden Infant Death Syndrome Advisory Council
 
Judith Cranmer
Nutritionist
Public Health
For being instrumental in launching the Monument Community Shuttle Bus to transports clients from their neighborhoods to various community programs and clinics in the Concord area free of charge. For her many hours of dedication and perseverance over two years to realize the vision of improving transportation services for Women, Infant and Children Program clients and others.
-Nominated by Shawn Sekel
 
Vaya Wilde
Senior Disease Intervention Technician
Public Health
For her calm, reassuring and proactive approach to securing medical treatment for a client, conducting research to help locate a clinical provider more attuned to the client needs and cutting through red tape to ensure he received necessary treatment.
-Nominated by a Client
 
Marina Rowoldt
Program Specialist I (WIC Site Program Manager)
Public Health
For her managerial skills, her dedication to team building, and going above and beyond the line of duty to provide excellent customer service to WIC participants at the Pittsburg WIC site.
-Nominated by Raz Moghbel
 
Esther Gutierrez
Community Health Worker Specialist
Public Health
For providing extraordinary, consistent and compassionate  service to low-income pregnant women with grace and ease. For her leadership, advocacy, mentorship and for being an information system champion.
-Nominated by Raz Moghbel
 
Mary Jane Kiefer
Senior Nutritionist
Public Health
For her excellent work on breastfeeding support and promotion throughout the county.
-Nominated by Raz Moghbel
 
Leigh Pierson Brown, FNP
Public Health
For the kindness and compassion she shows for her patients.  For being a wonderful co-worker who creates a supportive family-like environment for us.
-Nominated by Sue Meltzer
 
Teresita Medina
Home Economist
Public Health
For her attention to details, excellent service to our customers, her dependability, and for her ability to get along well with everyone.  For putting a smile on my face when I walk into the office.
-Nominated by Monique Sims
 
These recognitions originally appeared in the December 2016 and February 2017 issues of the Director's Report.
Employee Recognition
Marta Rincon
Community Wellness & Prevention Program (CWPP)

For winning a grant from the Contra Costa County Emergency Preparedness Team that supplies emergency survival kits that CWPP employees who primarily work in community settings can keep in their cars.  The grant also provided funds for emergency kits to be stored in the building for employees who primarily work in the office.

- Nominated by Tracey Rattray
Ana Villalobos
Community Wellness & Prevention Program (CWPP)

Congratulations to Ana Villalobos, Health Education Specialist for the Safe Routes to School Program, for receiving the Annual Women of Distinction award from Soroptimist International of Diablo Vista for making a difference in the lives of residents in the Monument Community.  Most recently, Ana engaged the Monument Community in pedestrian and bicycle safety by conducting community assessments, facilitating trainings at schools and in the community, and getting sponsorships to purchase bicycles and helmets for low income children. 

- Nominated by Tracey Rattray
March 2017
Director's Message
Dan Peddycord, Public Health Director
Why Public Health Matters More Than Ever
Our newsletter has a name! Thanks to the nearly 150 staff who voted among several options for newsletter names. PH Matters was the top vote getter and we are proud to use this name as it conveys the importance and relevance of what we do in Public Health. That is something particularly important at this time in our history.
 
As CCHS Director Dr. William Walker noted in the February issue of the Director's Report, we have been inundated with reports on the future of the Affordable Care Act, including what may or may not become of Medi-Cal expansion and Covered California. Those two components of Obamacare have afforded insurance coverage to more than 110,000 additional residents across Contra Costa. The idea those residents and others may lose their health insurance is unsettling. Add to this the concerns surrounding immigration and we are starkly reminded just how much Public Health does indeed matter.
 
Serving the Most Vulernable
Our profession has long served the needs of those who have few other options, the most vulnerable of our neighbors. We have long been a voice of fairness, equality, access and an advocate for the health for all people. We will continue to do so and we will maintain a clear focus on our mission to protect and improve the health of all communities in Contra Costa County. We will continue to address health and social equity through the wide range of things we do from assessment to prevention and from advocacy to service delivery. In the midst of the rhetoric and debate going on at the national level, we continue to offer compassionate care, work with our partners to expand services and promote the health of our communities.
 
I'm pleased to share a few examples. Just this past December the Board of Supervisors adopted a local ordinance for safe disposal of unwanted medications. The idea is to establish drop off kiosks at participating retail pharmacies and also to offer mail-back services. On another front, our FMCH team is poised to expand their work with Early Head Start, thanks to their efforts to successfully negotiate a three-year interagency agreement with additional funding. In addition, our efforts in CWPP have recently helped secure funding to complete park improvements at Meadow Hills and Ellis parks in Concord. Add to this the breaking news that our Tobacco Prevention Program is poised to receive over $900,000 in annual funding from the recently passed Prop. 56 - the voter-approved increase in the state tobacco tax.  

Substance Abuse Prevention
County Proclamation, Health Advisory Draw Attention to Opioid Epidemic
The Contra Costa Board of Supervisors proclaimed March to be Prescription Drug Abuse Awareness Month at its March 21 meeting, part of a statewide effort to draw attention to an epidemic that causes thousands of deaths nationwide every year.
 
The Public Health Division has reissued a health advisory regarding its efforts to combat opioid painkiller misuse in the community, calling on all providers to follow the Alameda-Contra Costa Medical Association's prescribing guidelines.
 
The advisory also details community efforts to raise awareness about the national epidemic and the local expansion of medication-assisted treatment and other substance use disorder (SUD) services.
 
Read the health advisory here . For up-to-date information about California's opioid epidemic, including county statistics for deaths, overdose-related visits to emergency departments, and per-capita prescriptions for opioid medications, visit the California Department of Public Health's new Opioid Overdose Surveillance Dashboard

Tobacco & Alcohol Prevention
New Data Show Tobacco, Alcohol and Sugary Drinks Still Being Promoted to Youth in Contra Costa

The Tobacco Prevention Program partnered with the Alcohol and Other Drugs, HIV/AIDS, and the Nutrition and Physical Activity Promotion programs on a survey of unhealthy products being sold in Contra Costa stores.

The survey assessed 221 stores that sell tobacco in Contra Costa and showed that 77% sell tobacco products near schools with youth-friendly flavors like watermelon, tropical blast and cherry limeade. In addition, many flavored cigarillos and little cigars sell for under $1, making them attractive and affordable to youth.

The findings also show that electronic cigarettes are widely available in Contra Costa. Close to two-thirds of stores in Contra Costa sell e-cigarettes, battery-operated products that turn nicotine and other chemicals into an aerosol that is inhaled by the user. Other data showed 77% of stores that sell alcohol and tobacco sold "alcopops," sweetened alcoholic drinks available in single bottles or cans that often resemble energy drinks popular with youth.

The Contra Costa County survey data was released on March 8 as part of a series of 13 regional press events throughout the state highlighting Healthy Stores for a Healthy Community, a 10-year statewide campaign to improve the health of Californians.

The Contra Costa Board of Supervisors is concerned about the survey results and has directed Public Health staff to draft policies that will protect youth from flavored tobacco products, including flavored electronic smoking devices, prohibit small packs of little cigars and cigarillos, and reduce the number of stores selling tobacco products near schools.

Public Health Nursing
Case Management for Foster Children On Psychotropic 
Medications
On February 13, 2017, the Contra Costa Health Services Child Health and Disability Prevention program received from the state of California $149,153 for fiscal year 2016-2017 to fund public health nurse monitoring and oversight of foster children treated with psychotropic medications. The primary responsibilities of the public health nurses are to administer case consultation with the Employment and Human Services Department and foster care parents/facilities, and to coordinate health care needs of foster care children on psychotropic medications.
 
California mandated public health nurse oversight of foster children taking psychotropic medications via state Senate Bill 319, signed into law in 2015. The law aims to reduce the over medication of California's foster children. Three FTE public health nurses will lead the case management teams in our county, where about 200 foster children are on psychotropic medications.
 
Foster care children have complex medical, behavioral health and educational needs that require long-term intensive and comprehensive case management services. These youth will receive in-person and telephone case management services, comprehensive care plans that include a social needs assessment and self-management health skills and other life skills.

Clinic Services
Clinic Expands Homeless People's Access to Dental Care
Homeless people often experience poor oral health and face multiple barriers to care, and more than half of homeless adults in the U.S. haven't received dental care in over two years. Public Health Clinic Services (PHCS) has been addressing this problem through its dental clinic at the Philip Dorn Respite Center for the Homeless in Concord. Since launching the dental clinic at the Respite Center in July 2015, the dental team has provided cleanings, fillings, extractions to 300 patients during more than 900 visits. To date, 26 patients have received dentures.
 
"For years, homeless clients seen in the clinic at the Respite Center have been requesting dental services," said Rachael Birch, program director for the Health Care for the Homeless program. "Adding these services to the Respite Center where clients are already receiving health care has been a great addition to our clinic."

Dr. Preeti D'Souza, the PHCS dentist who provides services at the Respite Center clinic, has also begun conducting dental education and assessments at local homeless organizations and shelters and with the Health Care for the Homeless Medical Street Outreach team, which serves those living on the streets and in encampments.
 
In fall 2017, Public Health Clinic Services will add two mobile dental clinics to expand access to dental services at homeless shelters in East County and Central County.

HIV/AIDS
Data Surveillance Helping Prevent Spread of HIV
Our Contra Costa Data-to-Care program is using surveillance systems in an untraditional way to reduce the spread of HIV and STDs in our community. 
 
The program uses STD and HIV data to target follow up for people at high-risk for contracting HIV and/or HIV-positive individuals with a recent coinfection with an STD. Program staff call those identified and offer risk reduction services, partner services, and, in the case of people who don't have HIV, Pre Exposure Prophylaxis (PrEP) navigation services. 
 
Two months into the implementation phase, the Contra Costa Data-to-Care program has identified and linked to care two newly diagnosed HIV positive people, enrolled three into the PrEP Navigation Program, linked eight ito STD care, and provided 85 risk reduction sessions. Next steps for the Data-to-Care program include gathering input of key stakeholders and educating the public and medical providers about PrEP. 

For more information, please contact Tracey Walker, PrEP Navigation Coordinator at (925) 313-6672.
School-Based Clinics
Clinics Providing Healthcare and Educational Services at Schools in the County
Contra Costa Health Services' School-Based Clinics (SBC) Program has increased students' access to behavioral, dental, health education, and medical services in six school districts throughout Contra Costa County. In collaboration with Antioch, John Swett, Pittsburg, Mt. Diablo, West Contra Costa, and Liberty Union High School Districts, the SBC Program provides services at 25 middle and high school sites. During the 2015-2016 academic year, there were nearly 11,400 visits by middle and high school students. 

To ensure the SBC program is fully integrated into the schools while developing and fostering relationships, health education specialists, mental health clinicians, and dental staff are assigned to specific school sites Monday to Friday. In collaboration with nurse practitioners, RN's, dentists, registered dental assistants, mobile clinic operators and clerks, the SBC program works to provide excellent behavioral, dental and medical services using a team approach.

CCHS school-based clinic services provides primary/preventative care such as annual comprehensive well child exams & sports clearances, immunizations, minor sick care upon parental/guardian/caretaker consent. Confidential reproductive care services are also available, which are delivered through a client-centered, compassionate, and youth-friendly manner.

Personnel
Paul Leung
New Head of Communicable Disease Programs Named 
Paul Leung has been selected as our new chief of Communicable Disease Programs. Paul has been serving as the interim chief since this past summer and for the past five-plus years has served as our Immunization Program coordinator. Prior to that, Paul worked for us as a senior disease intervention technician, so he brings a wealth of hands-on experience and insight to his new role. Paul earned a master's degree in public health with an emphasis in infectious disease from UC Berkeley. He also has an undergraduate degree in microbiology from UC Davis.  

Trainings
Perinatal Bereavement Training, May 11-12 
The Contra Costa Health Services Perinatal Bereavement Task Force will be utilizing the "Resolve Through Sharing (RTS) Bereavement Training: Perinatal Death" model developed by Gunderson Health System in 1981 for a two-day training in Pleasant Hill on May 11-12.

The Resolve Through Sharing (RTS) model is a comprehensive 2-day training known world-wide as the "Gold Standard" in perinatal bereavement education. The CCHS Perinatal Bereavement Task Force (Fetal Infant Mortality Review Program and Contra Costa Regional Medical Center & Health Centers staff) will be the first to offer this training in Contra Costa County! 

The target audience for the training includes nurses, social workers (all levels of practice), public health nurses, home health workers, chaplains, midwives, genetic counselors, physicians/physician assistants, child life specialists, ultrasound sonographers, lactation consultants, and funeral directors. More info

Obesity Prevention
Funds Support Healthy Activities in San Pablo
Community Wellness and Prevention Program (CWPP) staff, working with the San Pablo Childhood Obesity Prevention Task Force, were able to secure $50,000 from the San Pablo City Council last May to pay for health-promoting activities in the city. Some of the funding has been used to offer San Pablo residents low-cost physical activity classes such as Zumba, swimming, and children's soccer. The full list of classes can be found on page 13 of the city's Winter/Spring recreation guide. The task force is currently working to use some of the remaining funds to bring more cooking classes into the community. This is the second year in a row that the city has allocated funding for low-cost activities that are part of a comprehensive approach to reducing childhood obesity rates.
 
If you have questions, please contact Coire Reilly of CWPP at Coire.Reilly@hsd.cccounty.us. 

Infant Health Programs
News Story Examines Link Between Racism and Birth Outcomes 
A December 2016 story in the Richmond Confidential examined how racial stress can affect the health of infants and what kinds of programs there are for expecting mothers and newborns. The story quoted Natalie Berbick, manager of our Infant Health Programs, including Black Infant Health. Click here to read the story. 

Health Care for the Homeless (HCH)
From Left to Right : Jennifer Machado (Retired CFO & Trinity Center Volunteer), Dr. Wendel Brunner (past PH Director), Robin Heinemann (Retired Police Lieutenant, Concord PD), Matt Rinn (Pleasant Hill City Council), Shayne Kaleo (Anka Behavioral Health), Larry Fairbank Sr. (Concord Respite Shelter), Bill Shaw (Winter Nights Shelter).  Not Pictured: Bill Jones, Nhang Luang, & Belinda Thomas. 

New Governing Board Oversees Health Care for the Homeless
The Health Care for the Homeless (HCH) program  now has a new co-applicant governing board consisting of consumers and community members with varying skills, expertise, and experience regarding homelessness. 

The board currently includes members from Anka Behavioral Health, Reach Fellowship International, Winter Nights Shelter, Contra Costa Interfaith Housing, past employees of the Concord Police Department, Pleasant Hill City Council, Employment & Human Services Department and former CCHS past employees. This board oversees, guides, and assists the program in its efforts to deliver high quality health care to a diverse and medically underserved population in coordination with the County Board of Supervisors.
 
Since its first meeting in November 2016, the co-applicant board has played a huge role in the implementation of the new HCH clinic schedule , staff position selection, and approval of program policies. The HCH Program is very excited for the future of this board and looks forward to working together to best serve the homeless population here in Contra Costa County.
 
The Co-Applicant Board is actively looking for new members that are interested in bringing their expertise to assist the program in improving the health and wellness of homeless within Contra Costa County. The board meets every third Wednesday of the month at 597 Center Avenue and is open to the public. Please refer to the Co-Applicant Board website for more information about meetings, member roster, and board presentations.
Director's Message (continued)message
Introducing CommunityConnect
We also remain focused on implementing the Whole Person Care Initiative - and have chosen the name CommunityConnect to identify our local project. This very important initiative will provide an opportunity to expand case management, and social needs assistance to the most vulnerable of those we serve. Under the umbrella of CommunityConnect we will be leveraging the expertise of our public health nurses, social workers, community health workers, and other allied health staff to better coordinate care and help navigate our clients to essential community resources and services.  
 
To close with another bit of other good news, those of us who work at Center Avenue will be pleased to hear the City of Martinez has announced plans to improve the safety of the crosswalks between our building and the Nob Hill Shopping Center in the spring.
 
So be heartened by the good work we do, our commitment to serving the community, and our resolve to stay true to our mission. It matters!