2014 Annual Report.indd - Mobile County Health Department

2014 Annual Report.indd - Mobile County Health Department

MCHD ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG 2014 TABLE OF CONTENTS FROM THE HEALTH OFFICER ADMINISTRATIVE SERVICES FAMILY HEAL...

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MCHD ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

2014

TABLE OF CONTENTS

FROM THE HEALTH OFFICER

ADMINISTRATIVE SERVICES

FAMILY HEALTH CLINICAL SERVICES PREVENTION AND WELLNESS

ORGANIZATIONAL CHART

FINANCIAL STATEMENT BOARD OF HEALTH

Dr. Henry J. Koch Chairman

Dr. Nina Ford Johnson Secretary

Dr. Aimee H. Walsh Member

Dr. George T. Koulianos Member

Dr. Edward R. Flotte Member

Dr. D. Lawrence Bedsole Member

The Honorable Connie Hudson President, Mobile County Commission

The Honorable Merceria L. Ludgood President, Mobile County Commission

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MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

FROM THE HEALTH OFFICER

We are pleased to present this annual report for the October 2013 - September 2014 fiscal year. During that time, as always, our staff worked diligently to expand the efforts of the Mobile County Health Department’s mission, promoting, improving and protecting the health of those who live and work in Mobile County. As we approach our 200th birthday in 2016, I want to share highlights from the past year that are shaping our agency’s future in a positive way. We have embarked on a dynamic process to create fundamental change for the better at MCHD. After months of research, we contracted with Moran Consultants in 2014 for essential services training for all staff and managers. The process for a culture shift has included a staff survey, interviews and focus groups, along with agency-wide customer service training that will ultimately lead to an enhanced patient and staff experience across the 500-employee public health organization. MCHD and Family Health continue to serve more patients and clients each year. So it’s more important than ever to recognize that how we treat each other and the public affects all aspects of our agency. Here are some of the other highlights from 2014: The Assistant Health Officer position was reauthorized for MCHD. The Dauphin Island Parkway Health Center opened in April 2014, in a community where the needs of school-age children and their families are many. Also in April, Family Oriented Primary Health Care Clinics Inc. launched a new name – Family Health – and a website,

FamilyHealthAlabama.org that also features a modern new logo. MCHD also introduced a new website in 2014 that offers more information to patients and clients. In an innovative move, the Women, Infants and Children (WIC) supplemental nutrition program opened a drive-thru at the Southwest Mobile Health Center in Tillman’s Corner to better serve clients. MCHD’s Public Health Advisory Board, known as Women Making a Difference, received private grant funding of nearly $220,000 to create a kayak launch and to install sidewalks along a section of Three-Mile Creek at Tricentennial Park. A new community event, Creek Fest, is being planned to celebrate the revival of Three-Mile Creek. The Program Services Division, with some 180 staff members, was renamed Prevention and Wellness, and is now led by Kelly Warren. Within that division, Food and Lodging also was renamed Inspection Services to better reflect the services they provide in the community. Nutrition Services was renamed Social and Nutritional Programs. The WIC program, with more than 13,500 participants, had an impact of more than $10 million in Mobile County in 2014. To better recognize staff, MCHD launched a new employee appreciation program known as GEM – Going the Extra Mile, in January 2014. There were 16 individual winners and nearly a dozen teams recognized for their exemplary service to customers, patients and each other. We were disappointed the TEEN Center’s Healthy Start grant wasn’t renewed by the federal government. The non renewal resulted in a loss of revenue and a decrease in our workforce.

Bernard H. Eichold II, M.D., Dr. P.H., F.A.C.P. Health Officer

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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ADMINISTRATIVE SERVICES

The Administrative Services division is responsible for providing professional and technical services to internal departments, the public, third parties and other government agencies. The Director of Administrative Services provides oversight to the Bureau of Administrative Services, Information Technology (IT), Administrative Services Support, Physical Plant and Equipment, Safety, Performance Improvement, Emergency Preparedness, Medical Reserve Corp., Finance, Patient Billing, Purchasing and Contractual Services, Property Management, Human Resources, Benefits, Medical Staff Coordination, Staff Development and Training.

chiller system; upgrading the fire and security system; replacing several building roofs. Safety Management In 2014, the MCHD hired a Safety Officer to oversee organizational safety. The position conducts internal fire drills and other life safety code drills, directs the Safety Committee, reviews, revises and creates policies and procedures related to safety and Environment of Care standards of the Joint Commission, performs risk assessments and other duties. Performance Improvement

Information Technology Department MCHD’s Information Technology (IT) Department is responsible for all information technology services, including the Voice over Internet Protocol (VOIP) phone system. During 2014, the IT department, which includes a staff of 10, changed its name from MIS to IT. The department focused on security and application of computers and telecommunications equipment to store, retrieve, transmit and organize data. Various network and hardware upgrades were made during the year. Administrative Services Support The Administrative Services Support Director has direct supervision over Physical Plant and Equipment and Safety Management. Physical Plant and Equipment In 2014, Physical Plant & Equipment (PPE) monitored 21 facilities owned or leased by MCHD throughout Mobile County. The department employed 26 full-time and 29 parttime staff who completed projects including: adding a Women’s, Infants and Children (WIC) drive-through window; replacing the exterior of the Southwest Health Center back building; renovating store front property on Dauphin Island Parkway for a new clinic; upgrading a

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In 2014, the Performance Improvement Leadership Committee (PILC) met throughout the year to discuss improvement initiatives and review data. Five Performance Improvement (PI) Teams used the Plan, Do, Study, Act (PDSA) process to further agency goals. Various internal clinical audits were performed. Patient Satisfaction Surveys were conducted in April and October. Multiple policies were revised in preparation for the 2014 Health Resources and Services Administration (HRSA) site visit. Training was provided on PI regarding The Joint Commission requirements, peer review and clinical issues at New Employee Orientation, Provider Meetings, Medical Review Committee, Nurses’ Meetings and clinical staff meetings. Several high priority PI goals were achieved in 2014 including medical peer review becoming electronic and a five-fold increase in clinic audits with the assistance of an additional PI Assistant. Emergency Preparedness In 2014 the Emergency Preparedness (EP) Team provided Medical Needs Shelter training to 49 employees, facilitated the Mobile County Healthcare Emergency Response Coalition’s (HERC) monthly meetings, created HERC bylaws and elected members from 17 different organizations including, public health, hospitals,

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

ADMINISTRATIVE SERVICES

EMA, EMS, behavioral/mental health, nursing homes, community health centers and other disaster response agencies. The EP team, along with other MCHD employees, participated in several exercises and training drills including the Strategic National Stockpile (SNS) and Regional Distribution Site (RDS) drill. Other trainings and educational resources attended include: the Preparedness Summit in Atlanta, Georgia, CDC Division of Strategic National Stockpile Mobile Preparedness Course, Airport Tabletop Exercises, SMORT Bio-Seal Containment Training, Ebola Tabletop Exercise, and Advanced Regional Response Training Center (ARRTC) Healthcare Coalition Road Show. The EP nurse participated in Ebola training for MCHD employees. Training included Ebola education and a demonstration of Personal Protective Equipment (PPE) donning and doffing techniques. The EP nurse was also selected to serve on NACCHO’s Preparedness Policy Advisory Group (PPAG) for a two-year term, representing the state. Medical Reserve Corp In 2014, the Mobile Medical Reserve Corp (MMRC) participated in education and training activities. Trainings attended include the Advanced Regional Response Training Center (ARRTC) Roadshow, the Special Medical Operations Response Team (SMORT) Bio-Seal Containment Training, numerous Federal Emergency Management Agency (FEMA) courses, Alabama Department of Public Health (ADPH) Volunteer Symposium, Boy Scouts Emergency Preparedness Training, summer education series with Covenant Hospice, Disaster Mental Health training and webinars. Staff gave blood pressure checks at events and provided hundreds of hours of community service. Bureau of Finance The Bureau of Finance has direct supervision over Finance, Patient Billing, Purchasing and Contracting, and Property Management.

Finance The Finance Department produces biweekly payrolls, records cash collections through accounts receivable, pays vendors through accounts payable, produces various financial statements and reports weekly, monthly, quarterly, and annually for managers and governing bodies, files grant billings for reimbursements, produces the yearly organizational budget and maintains the budget throughout the year, prepares various federal reports such as the Medicare Cost Report and Uniform Data Systems report, reconciles bank statements, processes travel requests and provides other internal financial functions. Patient Billing In 2014, the Patient Billing Department processed over 141,579 primary claims and 11,822 secondary claims for 43,432 patients which were billed to Medicaid, Medicare, Blue Cross and Blue Shield, All Kids, Mom Care, Private Pay, Alabama Breast and Cervical Cancer Early Detection Program, and other Third Party agencies. Payments were posted electronically for Medicaid, Blue Cross, Medicare, USA OB, Champ VA, Cahaba Flu, and Mom Care. Claim types included medical, dental, family planning, EPSDT, immunizations, maternity, mental health, optometry, nutrition, case management, substance abuse, and lab. Claims were reviewed for proper coding, insurance coverage, referrals, and collection of co-pays, grant statistics, and other program requirements. Claims were filed electronically to most payers. Insurance verification was performed electronically. The department participated in a strategic planning team responsible for implementation of the new ICD-10 codes. The department also reviewed the entire Meaningful Use (MU) reporting in the Electronic Health Record and uploaded all data in the national and state registries.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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ADMINISTRATIVE SERVICES

Data for grant reporting and special billings were completed for Uniform Data System (UDS) Reporting, Title X, Ryan White, United Way, Teen Pregnancy Prevention Grant, Refugee Screenings, Louisiana Public Health Institute (LPHI) and Meaningful Use. Data for clinical audits were also provided by random sampling. Purchasing and Contractual Services During 2014, the department processed a total of 9,122 requisitions for goods and services. Purchasing Policies and Procedures were updated to include purchasing cards and electric requisitioning software usage instruction. Also, during the year 2014, a purchasing manual was adopted. Property Management In 2014, the Property Management Department was created and a Property Officer was named. The Property Management Department, works hand in hand with the Purchasing Department to track fixed assets, manage two warehouses, and store and dispose of unused fixtures, furniture and other equipment. During 2014, the department tracked agency fixed assets, maintained two warehouses for document storage and surplus items, and organized the sale and final disposition of property that has reached the end of its useful life. The Property Officer organized and developed an action plan to store, track and retrieve MCHD items. Non-current medical records were added to a cataloguing system to ensure accurate and prompt records retrieval. Two laborers were hired to work in the warehouse to assist in completing work orders of property placement, 820 work orders were completed by the warehouse team. The fixed assets were updated and adopted for Warehouse Management and Property Control.

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Human Resources During 2014, the Human Resources Division provided services to an average of 497 employees. This total was made up of 236 merit employees and 261 non-merit staff. MCHD hired 103 and promoted 31. A total of 92 employees separated from the organization during the year, including nine retirements and one death. A total of 568 W-2’s were processed in 2014. Insurance and Employee Benefits In 2014, the department initiated a program to offer information about retirement options, added Medical Nutrition Therapy (MNT) to the medical benefit program, added wig benefits for medically related conditions to the medical plan, implemented a new Employee Assistance Program (EAP), removed vision cap for 19 years and younger and submitted the first Affordable Care Act (ACA) payment. Medical Staff Coordination During 2014, the Medical Staff Coordinator (MSC) credentialed and privileged 38 providers. The MSC functioned as the employee health nurse and participated in new employee orientation; organized the Annual TB Skin Tests for the Clinic Staff and assisted with Ebola Training. Organized the Contract and affiliation agreement files for the colleges and universities and developed a spreadsheet to track the deadlines. The MSC revised the Student Assignment policy and streamlined the way students are assigned to medical providers; placed over 200 students with preceptors and designed a new system to track placement. The MSC organized the quarterly nurses meetings which were held in January, April, June and September. The MSC completed Clinical Site Checks and Mock Medical Competency Drills quarterly at each clinic. The MSC revised the Emergency Response Code Team and the Nursing Organizational Chart. The MSC represented the Health Department as a nurse liaison at Remington

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

ADMINISTRATIVE SERVICES

Three months after launching a new employee appreciation program, Going the Extra Mile, or GEM, the first team awards were announced April 4, 2014, during a party for the employees being recognized. Health Officer Dr. Bernard Eichold revealed the team winners and gave the traveling trophy to MCHD’s Finance Department.

College, University of Mobile, Fortis College, Virginia College, Bishop State Community College, the University of South Alabama and the Chamber of Commerce Healthcare Occupations Career Fair. The MSC attended the FHCS staff, KRONOS software, Primary Care Medical Home, PILC, Safety Committee, Administrative Services Staff, and Management Council Meetings and was a member of the Anticoagulation Team and High Alert Medication Team. The MSC organized the Annual Skills and Equipment Assessment where 60 Clinical Nurses and Medical Assistants were assessed. The MSC completed the Medical Management Chapter for the Focused Standards Assessment for Joint Commission. The MSC scheduled 18 New Medical Employees Clinical Orientations; revised and reviewed over 40 policies and attachments; organized, supervised and scheduled Summer Scrubs; assisted with Flight Physicals; attended CPR Instructor Training and recertified 53 employees in 10 CPR classes. Staff Development and Training The Staff Development and Training department provides ongoing training consultation, curriculum development, and survey manage-

ment for all departments. Staff Development and Training expanded its staff to accommodate training initiatives in the agency. These include updating orientation for 93 new employees and 100 non-employee students and interns, restructuring online poster training for all 500 employees, participating in the agency-wide Ebola training plan for all employees, offering customer service and stress management training for all staff at biannual agencywide meetings. Approximately 116 staff participated in safety training (91 in defensive driving, 10 in back & lifting, 15 dental radiation safety), 260 staff participated in infection control training (blood borne pathogens training for 250 clinical staff & new employees, 10 custodial workers), and 28 staff participated in MS Outlook training. The department developed 18 surveys for training, scheduling, and informational purposes. The department provides ongoing scheduling, training consultation, curriculum development, and survey management for requesting departments. The department maintains training records for all staff.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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AT A GLANCE: 2014

$

35,579,631 FISCAL YEAR REVENUE

$

80,054,170

COMMUNITY ECONOMIC IMPACT

SEPT 30, 2013 - SEPT 30, 2014

45

611,771

PROGRAMS

COMMUNITY CONTACTS

9

1,644

HEALTH CENTERS

AREA SERVED SQUARE MILES

497 STAFF

12 INCORPORATED CITIES

415,123 TOTAL MOBILE COUNTY RESIDENTS

1816 YEAR FOUNDED IN

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MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

NEW HEALTH CENTER OPENS

Community leaders took part in a ribbon cutting ceremony for Family Health’s newest health center opening. From left to right, B.C. Rain principal Marlon Firle; Shayla Beaco, city of Mobile Mayor’s Office; Pillans Middle School Principal Edward Henderson, B.C. Rain administrative intern David Weems; Mobile County Public School Superintendent Martha L. Peek; Family Health Governing Council vice president Mervin Thomas; Family Health’s Dr. Mark Donahue and Family Health’s Dr. Linda Davenport.

Family Health, a division of the Mobile County Health Department formerly known as Primary Care, held the grand opening of its newest health center April 23, 2014, at 2601 Dauphin Island Parkway (DIP). MCHD Health Officer Dr. Bernard Eichold II and other community leaders spoke at the event. MCHD and Family Health strategically locate health centers in areas where access to quality primary care is most limited. In late 2012, the organization won a competitive national grant for $500,000 to pay for the renovation of the newest health center on DIP. In 2013, the Health Department and Family Health applied for and won a second competitive national grant for $650,000 from the U.S. Health Resources and Services Administration to pay for the annual operation of the Dauphin Island Parkway Health Center. This ongoing grant ensures the health center is open to serve the public for years to come.

open on weekdays from 7:30 a.m. to 6 p.m., offering pediatric and adult health care services and family planning. A behavioral health coach is available for patients. The Women, Infants and Children (WIC) Nutrition Program offers scheduled appointments monthly. The 4,300-square-foot facility features state-ofthe-art exam rooms, new equipment and experienced health care providers. Fees are based on a sliding scale chart and no one is turned away because of an inability to pay. In 1979, the Mobile County Health Department launched its primary care division as a way to provide quality health care in areas where the needs are the greatest in Mobile County. Thirty-six years later, a new name and logo were launched to reflect Family Health’s continuous commitment to providing healthcare for all generations. In 2014, more than 40,000 patients visited Family Health’s nine primary care sites across Mobile County.

The Dauphin Island Parkway Health Center is MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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FAMILY HEALTH CLINICAL SERVICES

MCHD’s primary care division, known as Family Oriented Primary Health Care Clinic (FOPHCC) has a mission to provide healthcare services to the underserved of Mobile County. FOPHCC recorded 141,297 encounters for 41,204 unduplicated patients in 2014. Grants, awards and revenue received:

$6,869,675

$1,086,302

$914,893

toward the general budget from Health Center Cluster funding from state government contracts, Breast & Cervical Cancer, Family Planning HIV, WiseWoman and maternity in foundation grants from Louisiana Public Health Institute and Lab Corps

$872,667

for Ryan White Part C services

$411,418

for Ryan White Part B services

$411,307

in Affordable Care Act Capital Development Grants

$359,878

for Expanded Services supplemental funding

$221,000

in Medicare and Medicaid EHR incentive payments for eligible providers

$211,471

for an increase to annual ongoing base funding

$27,768

as one-time supplement for high level of quality performance in UDS reporting

$28,527

from Catholic Social Services for work with the refugee population

$10,000

from Delta Dental Community Care Foundation for Dauphin Island Parkway dental

Downtown Health Center At FOPHCC’s downtown health center, 43,350 patient encounters were recorded by providers of the Adult, Pediatric, Dental and Ryan White clinics. About 7,700 care coordination encounters were provided and more than 1,250 nutrition visits were provided to patients. The X-Ray department received a bone density machine at the downtown health center. Urgent Care Urgent Care services were added at the downtown health center. Non-emergency care is provided Monday through Thursday until 9:30 p.m. Ryan White Services A total of 734 unduplicated HIV/AIDS diagnosed patients received primary health care services through the Ryan White Part B and Part C funded programs. FOPHCC expanded relationships with AltaPointe and Catholic Social Services, providing for increased case management support, increasing overall quality improvement. A nurse practitioner dedicated to providing weekday open access to primary HIV services provided an increase in infectious disease medical hours. All HIV related medications continue to be provided at no cost to patients. The University of South Alabama provides weekly and on-call medical support. The North Baldwin Clinic, located at the Baldwin County Health Department in Bay Minette, continues. Dental Services

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The Dental Clinic recorded 9,496 patient encounters at its sites in Mobile, Semmes, North Mobile and Eight Mile. The staff includes three full-time dentists, a part-time dentist, three full-time hygienists and support staff. The clinic targets patients 3-20 years of age and some specialty populations.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

FAMILY HEALTH CLINICAL SERVICES

Optometry Services

North Mobile Health Center

FOPHCC’s part-time Optometry Clinic generated 1,607 encounters. The clinic continues to partner with the Lions Clubs of Mobile and the Eye Sight Foundation.

With 9,855, patient visits in 2014, the North Mobile Health Center provides services in northern Mobile and southern Washington counties through medical and dental providers and support staff. MCHD’s Women, Infants and Children (WIC) program also is located there.

Saturday Clinic The Saturday Clinic provided medical and dental services to 872 patients. Open from 8 a.m. to noon, a range of services are offered including internal medicine, pediatrics, dental, immunizations, family planning and lab services.

Citronelle Health Center The Citronelle Health Center provided 7,732 patient encounters during the year. It is staffed with a part-time physician, a full-time midlevel medical provider and support staff.

Community Outreach Semmes Health Center Outreach initiatives focusing on early detection of breast and cervical cancer through screenings on the Mobile Medical Van continue. A provider is dedicated to the unit to increase outreach activities throughout the county. FOPHCC has partnered with VT Aerospace to do on-site screenings.

The Semmes Health Center targets migrant and seasonal farm workers in northwest Mobile County. The site provided 15,968 patient visits, with services by a part-time pediatrician, a full-time family practice physician, a full-time and part-time mid-level, medical

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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FAMILY HEALTH CLINICAL SERVICES

support staff, and a full-time dental team. The staff includes full-time Spanish translators/ clerks, and a bilingual case manager who offers ancillary services to Hispanic patients. Newburn Health Center The Newburn Health Center provided medical care to 7,594 patients. Most patients are children and adolescents. Staff includes a full-time pediatrician, a part-time mid-level and support staff. Eight Mile Health Center The Eight Mile Health Center recorded 10,856 patient visits. It is staffed by midlevel providers, a full-time pediatrician, a full-time dental team and support staff. Dauphin Island Parkway Health Center Dauphin Island Parkway Health Center opened in 2014. Two full-time mid-level and support staff recorded 4,236 patient encounters. Mental health services are provided.

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Women’s Health Center In 2014, the Women’s Health Center provided family planning, maternity care and home visit nursing services for a total of 27,912 patient encounters. Southwest Mobile Health Center Southwest Mobile Health Center in Tillman’s Corner offers pediatric, adult health and family planning services. There were 8,315 patient encounters recorded. The support staff includes a full-time pediatrician, 1 full-time and 1 part-time mid-level, medical support staff, a Spanish translator and a part-time dental team. Central Appointments Central Appointments staff answered more than 213,664 calls in 2014. The open access appointment model is used, offering same day/ next day appointments. Performance improvement processes were implemented: creation of electronic wait lists; appointment reminder call backs and call monitoring.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

GEM PROGRAM

Darlene Burrell

Natalie Briceno

Timothy Busby

James Currie

Dr. Kent Daum

Meredith Gardner

Wendy Hale

Laura Hanebuth

Lynn Mason

Margaret McCulloch

Denise Peele

Mitchell Price

Patricia Robinson

Amy Rosson

Janice Terry

Kendra Wilson

To better recognize those who delight customers and other staff members, a new employee appreciation program called GEM -- which stands for Going the Extra Mile -- was launched at the Mobile County Health Department in 2014. Employees are encouraged to nominate others when they see them going above and beyond their normal job duties. Groups of employees also can be nominated for Team GEMs. The program has been well-received, with hundreds of nominations electronically submitted throughout the first year. Here’s how the program works: Those who earn at least three nominations are reviewed by the GEM committee. Prizes are awarded based on the number of nominations received during a one-year time period. Nomination forms are available on MCHD’s Intranet page. In 2014, MCHD awarded 16 individual ruby GEMs. Any employee can nominate any other employee for the special recognition. Previously, MCHD’s employee recognition program excluded those in leadership positions and those who had been working for the organization for less than two years.

With the new program, the first level of recognition is known as the ruby GEM. Those who receive this recognition are awarded a simulated ruby lapel pin, a signed certificate, a balloon, two hours of comp time, inclusion in the MCHD newsletter and Facebook posts, among other promotional platforms. To receive a Team GEM, any employee can nominate a department or group for the special recognition. Each Team GEM group will receive certificates, balloons, a traveling trophy and inclusion in the newsletter, Facebook and other promotional platforms. The 2014 ruby GEM winners were: Amy Rosson, Meredith Gardner, Dr. Kent Daum, Natalie Briceno, Margaret McCulloch, Wendy Hale, Darlene Burrell, James Currie, Laura Hanebuth, Lynn Mason, Patricia Robinson, Denise Peele, Kendra Wilson, Mitchell Price, Timothy Busby and Janice Terry. MCHD and Family Health departments and groups recognized quarterly in 2014 with the Team GEM Traveling Trophy were the Finance Department, WIC, Immunizations and Marketplace Enrollment.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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PREVENTION AND WELLNESS

Fetal Infant Mortality The Fetal Infant Mortality Team reviewed 85 infant or fetal deaths. Thirty-two of the 85 cases were reviewed by the case review team.

fluence in relation to healthy birth outcomes, health status, socio-emotional and academic performance of their young children. Programming was facilitated at four sites, reaching 93 participants.

Pregnancy Prevention Programs

Social Services

The TEEN Center’s Health Education Department presented 1,032 sessions to 9,010 students in 28 schools in Mobile County.

The Office of Social Services coordinated social service case management activities throughout the Health Department in order to reduce barriers and increase access to health care.

Teen Pregnancy Prevention Programs, “Think Teen” partnered with 11 community-based organizations to provide education about adolescent sexual and reproductive health, with the goal of reducing teen pregnancy, STI and to delay the initiation of sexual activity. They reached a total of 2,911 students at 26 sites. Tobacco Control The Student’s Working Against Tobacco (SWAT) team made 144 presentations at 18 sites and reached approximately 3,600 children in grades 3 through 8. The Fatherhood Initiative The Fatherhood Initiative targets young fathers under the age of 25 providing programming to promote the benefits of positive paternal in-

Maternity Care Coordination Program staff at the Women’s Center provided support and follow-up care to 1,643 maternity patients with 450 deliveries. To help patients focus on good health care during pregnancy, the Maternity Care Coordination Program assisted patients in keeping appointments, arranging transportation, and addressing other psychosocial issues. The Family Planning Care Coordination Program assisted 800 women in applying for Medicaid’s Plan First program, and 1,600 Plan First patients were assessed for risk factors for unintended pregnancy. Care coordination services were provided to 1300 new patients determined to be high risk for an unintended pregnancy. 4200 unduplicated patients were assisted with compliance with their chosen birth control method, with reminders of appointments, and with transportation and other psychosocial issues. Patient First Children’s Care Coordination Program provided case management services for children up to their 21st birthday. Services were provided to 1,300 patients. Patients were referred for missed appointments, immunizations, EPSDT visits, and the need for referrals and assistance because of difficulty coordinating for themselves. Family planning care coordination was offered to teens seeking family planning services. Case

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MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

PREVENTION AND WELLNESS

management in this program was primarily provided in the patients’ homes. The Patient First Adult Care Coordination Program provided case management services to adults who were enrolled into the Patient First Program. Under this program, services were provided to 800 patients. Patients were assessed for unmet needs, and services were provided to assist them with transportation, referrals to needed agencies, and appointment reminders. For women under Medicaid’s Patient First program who presented for family planning services, case management was provided. Vital Records MCHD’s Vital Records department issued 49,155 copies of certificates, which included birth, death, marriage and divorce, for a total of $504,711. Nutrition Services

classes were also offered and attended by more than 179 patients. Nutrition Services is offered at MCHD’s downtown location, the North Mobile Health Center, Semmes Health Center and the Eight Mile Health Center. The WIC Breastfeeding Peer Counseling Program continues to improve breastfeeding rates. A team of five peer counselors and a certified lactation consultant aid participants in breastfeeding care and support. A total of 47% of the WIC participants breastfed their infants during the first year. This was a 20% increase since the program began in 2005. In October, the WIC Program opened its first drive-thru service in the state at the Southwest Mobile Health Center. The WIC program was awarded special U.S. Department of Agriculture funding in 2014 for this innovative concept in service delivery. Certified WIC participants that don’t need to be seen by a provider can be issued benefits without leaving their car.

A monthly average of 13,016 participants received Women, Infants and Children (WIC) food instruments during the year. This was a decrease of 364 participants in caseload over the previous year. The WIC Program estimated that $10,277,750.67 WIC food dollars were spent in Mobile County. The participation caseload consisted of three categories that included women, (pregnant, breastfeeding or postpartum), infants (birth to 1 year) and children (1 to 5 years). The Southwest Clinic recorded a record of 3,145 participants during 2014. The Teen Center Clinic assisted 2,911 WIC participants during the same time period. Those were the highest caseloads ever for those clinics. Through the Adult, Pediatrics and HIV clinics, a total of 1,165 patients received dietary counseling from registered dietitians. These counseling sessions included medical nutrition therapy (MNT) topics such as diabetes, hypertension, cholesterol, weight management and other related topics provided. Weight loss and diabetes

The Mobile County Health Department’s Women, Infants and Children (WIC) Supplemental Nutrition Program celebrated the opening of its first drive-thru window with a ribbon-cutting on Oct. 22, 2014 in Tillman’s Corner. The WIC program in Mobile County was awarded special U.S. Department of Agriculture funding in 2014 for this innovative concept in service delivery.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

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PREVENTION AND WELLNESS

The WIC Program opened a satellite clinic at the new Dauphin Island Parkway Health Center. This site is open one day a month. The Office of Nutrition Services coordinated the statewide Scale Back 2014 weight loss competition. The Health Department had 104 employees take part. A total of 418 pounds was lost by employees. Also, Nutrition Services coordinated and conducted a food drive during the holiday season. At least 913 pounds of food was collected, providing more than 702 meals to needy families. The Office of Nutrition Services partnered with the Junior League of Mobile, the University of South Alabama and the Mobile County Public School System to conduct an assessment study to determine the outcome of an evidence-based nutritional and fitness program intervention in sixth-grade students in Mobile County. As part of the assessment, registered dietitians weighed and measured more than 400 students in area middle schools. An ADPH grant entitled WISE WOMAN began in April and included referrals to our registered

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dietitians to provide the New Leaf Food Assessments and Tips and Healthy Eating Sections sponsored by the ADPH Office of Women’s Health. Eighty participants completed these education sessions and support groups. Also, a new Medical Nutrition Therapy (MNT) benefit for MCHD employees was initiated in 2014 which led to the credentialing of the Registered Dietitians in Nutrition Services as Out-of-Network Providers with BlueCross BlueShield of Alabama. Community Education Programs Community Education Programs (CEP), which includes marketing, public relations and graphics functions at MCHD, was responsible for launching and managing a new employee recognition program in 2014 known as GEM, or Going the Extra Mile. More than a dozen individuals and teams were recognized through social media, the newsletter and through other measures. CEP promotes the activities and mission of MCHD through internal and external campaigns and promotions via traditional and non-traditional platforms, including news releases, Facebook and Twitter posts.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

EMPLOYEE NEWSLETTER JAN-MAR 2014

July - Sept 2014

Culture

THE VOICE OF MCHD & FAMILY HEALTH

PLUS GO RED FOR WOMEN BLOOD DRIVE TOTALS

IN THIS ISSUE EMPLOYEE OF THE YEAR: JAMES CURRIE

WHY FOLLOW US ON SOCIAL MEDIA?

IN THIS ISSUE Meet Dr. Linda Davenport Visual phone directory: it’s totes mcgoats We go old school rules: Becky Dixon on germs zPlus, Aura Wellness Center gets a mini-makeover z

WE INTERVIEW: PAVONIA ADAMS, TONYA DOBBS MD, AND MARGARET MCCULLOCH

EMPLOYEE APPRECIATION DAY 2014

z z

FOOD & LODGING’S BRAD PHILIPS RECOGNIZED On the cover: Astronaut Kay Hire and Dr. Bert Eichold

The January-March 2014 edition of MCHD’s newsletter featured a story on Astronaut Kay Hire, who, along with Dr. Bert Eichold, planted new oak trees at Murphy High School to replace those destroyed by a tornado. Hire also visited the Health Department, talking to NASA Develop students and other staff.

The July-September 2014 issue of MCHD’s newsletter featured the photos of the health agency’s first six GEM award winners. The GEM program, which stands for Going the Extra Mile, was launched in January 2014 as a way to better recognize staff members.

October - December 2014

January - March 2015

Culture

THE VOICE OF MCHD & FAMILY HEALTH

IN THIS ISSUE

IN THIS ISSUE

Winter Wonderful Wrap-up Annual Door Decorating Contest zMonster Mash GEM Bash zPreparing for Scale Back Alabama zMCHD’s Fatherhood Initiative

The ‘Voice of MCHD’ retires after 16 years Susan Stiegler named Assistant Health Officer Officer Urgent Care clinic adds expanded hours zMCHD named ‘Employer of the Year’ zCreek Fest ‘15

z

z

z

z

The October-December 2014 issue of the newsletter included winners of a costume contest, photos and awards handed out during Winter Wonderful, and a feature on the Fatherhood Initiative, a program offering a strong foundation to young fathers.

z

The January-March 2015 edition of the MCHD newsletter included a story on the GEM winners from the fourth quarter of 2014, including photos of ruby award winners and the Team winner, the Immunization Department, with the traveling trophy.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

16

INSPECTION SERVICES Food and Lodging Inspections Establishments Permitted or Pending

2,784

Inspections

15,892

Plans received

497 General Sanitation Inspections

Hotels/Motels Permitted or Pending

85

Hotel/Motel Inspections

393

Number of Schools

115

School Inspections

381

Number of Detention Centers

9

Detention Center Inspections

31

Swimming Pools Permitted or Pending

271

Swimming Pool Inspections

536

Child Day Cares Permitted or Pending

151

Child Day Care Inspections

297

Number of Camps

3

Camp Inspections

2

Other Lodging Inspections

351

Other Sanitary Inspections

80 Special Event Inspections

Number of Events

47

Inspections

421 Tattoo Parlor Inspections

Tattoo Parlors Permitted and Permits Pending

17

Inspections

41

Total of Establishments and Special Events Inspected

3,482

Total of Inspections

18,597

Water Testing Water Samples Tested

2 Complaint Investigations

Food Service

218 Sanitation Courses

Trainees

17

17,798

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

ENVIRONMENTAL HEALTH Onsite Sewage Disposal Systems (OSS) Applications to Install/Repair 726 OSS

Mosquito Service Requests Investigated/Treated

Septic Permits Issued

568

Mosquito inspections

Complaint Investigations

105

Advanced Treatment Systems Approvals

14

9,251

Miles driven

68,850

Adult Mosquitoes Identified (Permanent Sites) Adult Mosquitoes Identified (Variable Sites)

Permits issued

828

Inspections

743

7 14 32

41 4,850 350

Mosquito Pools Tested

10

Mosquitoes Tested

150

Mosquito Pools Positive Sentinel Sera-Samples Tested

Subdivisions

1,214

Mosquito and Arboviral Surveillance

Mosquito Species Identified

Plumbing

Large Flow Developments Phase 1 Large Flow Developments Phases 2 & 3 Large Flow Developments Lot Inspections

Mosquito Control Activities

0 624

Positive Sentinel Samples (titers > 40)

6

West Nile Virus

1

Eastern Equine Encephalitis

5

Number WNV + Dead Birds

0

Total Dead Birds Submitted

2

Larviciding Larviciding Applications Gallons of Liquid Larvicide

6,925 290

Pounds of Granular Larvicide

8,303

Number of Briquets

42,281

Ground Adulticiding Adulticiding Routes

734

Spray nights

107

Gallons of Adulticiding & Diluents

5,685

Aerial Adulticiding Number of flights

1

Acres treated

Rodent Control Activities

Service Requests Received

1,075

Miles driven

29,633

Residential Inspections

6,620

Pounds of Rodenticide Used

2,165

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

18

DISEASE TRACKING Notifiable Disease AIDS/HIV Infections (combined) Brucellosis Campylobacteriosis Chancroid Chlamydia Cryptosporidiosis E. coli 0157:H7 Eastern Equine Encephalitis Ehrlichiosis Giardiasis Gonorrhea H. influenzae, invasive disease Hepatitis A Hepatitis B Hepatitis C Histoplasmosis Influenza deaths (<18 years of age) Legionellosis Leptospirosis Listeriosis Lyme Disease Malaria Meningitis, other N. Meningitidis, invasive disease Parotitis, Infectious (mumps) Pertussis (Whooping Cough) Rabies (animal) Rocky Mountain Spotted Fever Rubella (German Measles) Rubeola (measles) Salmonellosis Serious Community-Acquired MRSA Shigellosis Streptococcal Pneumonia Syphilis Tetanus Tuberculosis Typhoid Fever Varicella

19

Cases 121 1 33 0 2,937 17 6 1 0 11 659 3 0 0 0 2 0 1 0 0 1 1 0 0 0 83 0 2 0 1 88 0 41 14 53 0 8 0 3

Vibriosis

3

West Nile Virus Yellow Fever Yersiniosis

0 0 1

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

IMMUNIZATIONS

Pediatric

Adult

4

-

Diphtheria/Tetanus-Acellular/Pertussis (DTaP)

1,125

-

Diphtheria/Tetanus-Acellular/Pertussis Hepatitis B (recombinant) - Polio Vaccine, Injectable (DTaP/Hep B/IPV)

1,949

-

Diphtheria/Tetanus-Acellular/Pertussis Haemophilus B - Polio Vaccine, Injectable (DTaP/Hib/IPV)

581

-

Diphtheria/Tetanus-Acellular/Pertussis - Polio Vaccine, Injectable (DTaP/IPV)

1,126

-

Hepatitis A (Hep A)

5,313

278

Hepatitis B (Hep B)

586

265

-

268

Haemophilus Influenza Conjugate B (Hib)

2,316

-

Human Papillomavirus Quadrivalent Vaccine (recombinant) (HPV)

4,196

663

Influenza

1,620

5,173

941

112

Meningococcal Vaccine

2,193

199

Measles - Mumps - Rubella (MMR)

847

121

Measles - Mumps - Rubella - Varicella (MMRV)

2,058

-

Pneumococcal Polysaccharide Vaccine (PPV 23)

-

136

Prevnar 13 (PCV 13)

3,280

-

Tetanus, Diphtheria, Pertussis (Tdap)

1,966

806

Rotavirus

1,440

-

Tetanus/Diphtheria (Td)

85

93

Typhoid Vi

89

338

1,336

54

Yellow Fever

31

138

Zostavax

-

19

33,082

8,663

Diphtheria/Tetanus (DT)

Hepatitis A/B Combo (Hep A/B)

Polio Vaccine, Injectable (IPV)

Varicella

Subtotal Total

41,745

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

20

ORGANIZATIONAL CHART

BOARD OF HEALTH LEGAL COUNSEL Michael T. Murphy, ESQ.

COMPLIANCE/ PRIVACY OFFICER Susan Potts, ESQ.

DIRECTOR ADMINISTRATIVE SERVICES Paul Betros, M.B.A.

BUREAU OF ADMINISTRATIVE SERVICES Frank Mitchell, M. Ed., M.P.A.

INFORMATION TECHNOLOGY Steven Peyer, MS Data Security Officer

ADMINISTRATIVE SERVICES SUPPORT Helen Dials, M.P.A. PHYSICAL PLANT & EQUIPMENT Ron Chandonnet

HEALTH OFFICER Bernard H. Eichold II, M.D., Dr. P.H., F.A.C.P. ASSISTANT HEALTH OFFICER Joel W. Tate, M.B.A., F.A.C.H.E.

DIRECTOR PREVENTION & WELLNESS Kelly Warren, M.S.W., M.P.H.

HEALTH SERVICES ADMINISTRATION Marie Chastang, M.A.

PREGNANCY PREVENTION PROGRAM Pebbles King, M.B.A.

FAMILY ORIENTED PRIMARY HEALTH CARE GOVERNING COUNCIL

DIRECTOR FAMILY HEALTH CLINICAL SERVICES Susan Stiegler, B.S.N., M.P.H.

MEDICAL REVIEW COMMITTEE Gregory Evans, M.D. Tonya Dobbs, M.D Constance Cooper, M.D. Angelia Blackmon-Lewis, D.N.P.

HEALTH SERVICES ADMINISTRATION Angelia Blackmon-Lewis, D.N.P.

CLINICAL ADMINISTRATIVE SUPPORT Yatron Weatherly, B.S.

SEXUALLY TRANSMITTED DISEASES CLINIC Deborah Slocum, M.S.N.

North Mobile Health Center

Citronelle Clinic AREA XI STD Surveillance Paul Piepho, B.S.

Eight Mile Clinic

Tobacco Control SAFETY OFFICER Raffias Redmon, M.B.A., C.E.S.C.O. Safety Committee PERFORMANCE IMPROVEMENT Jayne Wilson, B.A. Performance Improvement Leadership Committee EMERGENCY PREPAREDNESS Vacant Medical Reserve Corps BUREAU OF FINANCE Collena Matz, M.B.A., C.P.A. Comptroller

Faith Based Initiatives

GRANTS MANAGEMENT & REPORTING Mark Bryant, B.S.

SOCIAL & NUTRITIONAL PROGRAMS Elizabeth W. Smith, M.P.A., R.D., L.D.

BEHAVIORAL HEALTH

AURA

SOCIAL SERVICES Carol Cannon, M.S.W. WOMEN, INFANTS & CHILDREN

HEALTH SERVICES ADMINISTRATION Missy Wilson, M.S., A.L.C.

BUREAU OF DISEASE CONTROL & ENVIRONMENTAL HEALTH Monica Knight, M.P.H.

IMMUNIZATIONS/TRAVELERS HEALTH Dan St. Onge, B.S.

CLINIC ADMINISTRATION Johndra Lewis, M.P.A.

WOMEN'S AND CHILDREN'S HEALTH CENTER

SEMMES CLINIC

WOMEN'S CENTER

SOUTHWEST MOBILE HEALTH CENTER

TUBERCULOSIS Megan M. Finnigan, B.S.

PATIENT BILLING C.W. Johnson, B.S. PURCHASING & CONTRACTUAL SERVICES Toni Wortham, M.S. PROPERTY OFFICER Daniel Stombaugh, B.S.

NEWBURN CLINIC EPIDEMIOLOGY Becky Dixon, B.S.N.

INSPECTION SERVICES Stephanie Crawford, M.P.H., D.H.Sc.

ONSITE Theodore F. Micher, B.S.

Finance HUMAN RESOURCES Peggy Howat, B.S.

DAUPHIN ISLAND PKWY CLINIC CENTRAL APPOINTMENTS

HEALTH SERVICES ADMINISTRATION Jillian Ransom, M.P.A.

CLINIC ADMINISTRATION Stephen Murray, M.S.

VECTOR SERVICES Jerry Folse

INSURANCE & BENEFITS Laura Stuart, B.S VITAL RECORDS LeAndrew Pears, B. S. MEDICAL STAFF COORDINATOR Denise Peele, R.N. STAFF DEVELOPMENT & TRAINING Jeanne Harris, M.B.A. Academic Affairs

COMMUNITY EDUCATION PROGRAMS Casandra Andrews, B.S.

CLINICAL ADMINISTRATIVE SUPPORT Alicia Mathis, B.S.

ADULT CLINIC RYAN WHITE

PEDIATRIC/ADOLESCENT CLINIC

XRAY

DENTAL CLINIC

SATURDAY CLINIC

OPTOMETRY CLINIC

MOBILE MEDICAL UNIT/ OUTREACH & EDUCATION

Media Relations Marketing

Approved:

____________________________________ Bernard H. Eichold II, M.D., Dr. P.H., F.A.C.P. Health Officer October 22, 2014

21

CLINIC ADMINISTRATION Valencia Patterson, B.S.N., M.H.A.

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

Local Government-County of Mobile

$ 825,984

Local Government-City of Mobile

$ 600,000

Local Government-Other Municipalities

$ 79,554

State of Alabama

$ 489,397

$ 825,984 $ 600,000 FY 2013

APPROPRIATIONS

TOTAL APPROPRIATIONS

$ 489,397 $1,994,935

$1,994,935

Eliminating Disparities

$ 1,471,273

$ 1,510,057

Diabetic State Funding

$ 9,750

$0

Food Stamp Nutrition Education

$ 35,728

$0

$ 5,945,234

$ 6,851,562

Primary Care Migrant Health

$ 170,739

$ 269,837

Family Planning

$ 409,681

$ 381,261

Maternity

$ 285,975

$ 285,078

Women, Infants & Children (WIC)

$ 2,516,427

$ 2,509,023

HIV/AIDS

$ 1,478,778

$ 1,295,611

$0

$ 51,210

Youth Empowered Tobacco Policy Initiatives

FISCAL YEAR ENDING SEPTEMBER 30, 2013 AND SEPTEMBER 30, 2014

FY 2014 $ 79,554

Tobacco Control

$ 54,865

$0

Community Putting Prevention to Work (CPPW)

$ 267,588

$0

Bioterrorism

$ 221,094

$ 158,548

Medical Reserve Corps

$ 52,421

$ 64,896

Breast and Cervical Cancer

$ 94,299

$ 133,261

Cancer Registry

$ 20,048

$0

Emergency Response - Tropical Event

$ 17,689

Teen Fund

$ 25,000

$ 35,000

Teen Pregnancy Prevention

$ 796,014

$ 1,267,556

Immunization

$ 233,142

$ 252,919

AAP HIV Surveillance

$ 14,175

$0

Refugee Preventive Health

$ 30,063

$ 29,947

STD Control

$ 61,314

$ 140,000

State Employee Wellness Screening

$ 52,536

$ 7,040

HIV Family Planning

$ 131,250

$ 232,917

ADPH - EDRS

$ 61,625

$ 36,973

AIDS Control - State of Alabama

$ 49,102

$ 79,486

LA Public Health Casper Study

$ 26,236

$0

GRHOP PCCP

$ 20,000

$0

LA Public Health BP Oil Contract

$ 110,739

$ 800,216

$0 FY 2013

GRANTS

FY 2014

REVENUES

Tulane GRHOP

$0

$ 58,300

Wise Woman

$0

$ 58,126

School Parenting

$0

$ 3,750

Responsible Fatherhood

$0

$54,709

TOTAL GRANTS Ad Valorem Taxes

$ 14,662,785 $ 4,369,566

$ 16,567,284 $ 4,370,646

Oil & Gas Severance Tax

$ 274,825

$ 261,824

Medicaid and Medicare

$ 8,818,552

$ 9,703,048

Reimbursement (State)

$ 164,103

$ 183,930

Reimbursement (Other)

$ 39,468

$ 19,131

Clinic Fees (Private Pay, Other Insurance)

$ 1,048,595

Local Fees, Permits, Misc.

$ 1,848,750

$ 2,055,324

Refunds and Interest

$ 62,273

$ 78,740

Sale of Fixed Assets

$ 1,277

$ 3,847

$ 115,990

$ 127,932

FY 2013

$ 1,283,435

FY 2014

OTHER

Rent Donations

$ 3,799 TOTAL OTHER

TOTAL REVENUES

$ 18,088,558

$ 33,404,918

$ 36,650,776

Personnel Costs

$ 22,735,975

$ 24,100,635

Contract Services

$ 3,389,688

$ 3,692,632

Travel

$ 207,182

EXPENDITURES

$ 242,670 FY 2013

Equipment

TOTAL EXPENDITURES

$ 700 $ 16,747,199

$ 1,111,580

FY 2014 $ 1,316,953

Supplies and Other

$ 4,387,183

$ 4,775,682

Land and Buildings

$ 1,142,568

$ 1,451,059 $ 32,974,176

MCHD 2014 ANNUAL REPORTMCHD.ORGFAMILYHEALTHALABAMA.ORG

$ 35,579,631

22

BERNARD H. EICHOLD, II, M.D., Dr. P.H., F.A.C.P. Health Officer

JOEL TATE, M.B.A. Assistant Health Officer

PAUL BETROS, M.B.A. Administrative Services

SUSAN STIEGLER, B.S.N., M.P.H. Family Health Clinical Services

KELLY WARREN, M.S.W., M.P.H. Prevention and Wellness

251 N. BAYOU STREET P.O. BOX 2867 MOBILE, AL 36652-2867 MCHD.ORG | FAMILYHEALTHALABAMA.ORG FACEBOOK.COM/MCHD.ORG TWITTER @MCHEALTHDEPT MCHDCULTURE.BLOGSPOT.COM