ADULT HEALTH

ELIGIBILITY

Any one 18 years of age and older. Patients seen by appointment.

SERVICES PROVIDED

• Blood pressure screening

• Diabetes screening

• Hemoglobin screening

• Urinalysis

• Cholesterol screening

• Any moderate elevations will receive counseling from a public health nurse

• Any high elevations will be referred to the patient’s physician for evaluation and treatment

• As staff time and CLIA guidelines allow, cholesterol, blood sugar, and blood pressure screenings will be offered in the community.

• Influenza vaccines and pneumococcal vaccines are offered according to guidelines set by the Davidson County Board of Health.

ELIGIBILITY TO ENTER THE PROGRAM

Any female age 40-64 years. Patients who have Medicaid, Medicare, or women receiving Title X services are not eligible. Symptomatic women under the age of 40 who do not qualify for Family Planning services can be seen if they meet the financial eligibility (250% of federal poverty level) and do not have Medicaid, Medicare, or Title X funding. Patients seen by appointment.

SERVICES PROVIDED

1. Health Screenings

2. Lab services

a. HIV screening if desired

b. Assessment of smoking

c. Height and weight

d. Blood pressure screening

e. Breast screening

f. Clinical exam

g. Teach breast self-exam

h. Cervical pap screening, as indicated

i. Bimanual pelvic exam, as indicated

j. Refer any abnormal findings to private physician

k. Mammography

Eligibility - Female over 40 years of age or over who is 250% federal poverty level. Eligible women will be referred as funds are available. Women less than age 40 with breast symptoms (i.e. lump or bloody nipple discharge) will be seen and referred as necessary. Patients will be referred to Lexington Memorial Hospital or Thomasville Medical Center for mammography services.

Screening mammography

Diagnostic mammography

Refer abnormal findings to private physician and/or surgeon

Ultrasounds

ELIGIBILITY TO ENTER THE PROGRAM

Women of childbearing age, who wish to postpone pregnancy or plan the spacing and number of pregnancies, whether a resident of Davidson County or another county; meet financial eligibility of greater than 250% federal poverty level.

PERSONS SERVED BY THE PROGRAM

Citizens receiving services and ultimately all of Davidson County. Appointment is required.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• Health history

• Physical examination

• Contraceptive supply

• Pap screening as indicated and referral

• STD screening as indicated

• Medical referral and follow-up

• Lab services (urinalysis, hemoglobin, syphilis) as indicated

• Clerical and data maintenance

• Pregnancy testing for program participants, if medically indicated

• Provide counseling regarding sterilization and family planning

• Referral to Region G Vasectomy Clinic

• Provide education

• Community education

• Patient education

• Encourage employee training and orientation

• Immunization assessment and administration as available

• HIV counseling and testing, if desired

ELIGIBILITY TO ENTER THE PROGRAM

Any Davidson County resident who is pregnant, uninsured, and meets the financial eligibility of great than 250% federal poverty level. An appointment is required. Women receiving Medicaid and/or other insurances will be referred to private OB/GYN clinics for prenatal care.

SERVICES AND ACTIVITIES

• Complete medical history

• Weight

• Height

• Blood pressure

• Body mass index (BMI)

• Laboratory tests

• Syphilis

• Blood type and RH factor

• Hemoglobin

• Rubella titer

• Sickle cell (as indicated)

• Toxoplasmosis screening (as indicated)

• Urinalysis, sugar, protein, ketones, leukocytes

• Tuberculin skin test (as indicated)

• HCG (as indicated)

• Hepatitis B screening

• AFP screening, if desired

• HIV testing if desired

• Pap smear

• gonorrhea testing

• Chlamydia testing

• Diabetic screening

• Varicella titer

• Strep B screeing

• Screen and educate all patients concerning preterm labor

• Complete physical examination, measurement of the uterine fundus, and auscultation of fetal heart

• Education sessions

• Nutrition

• Labor and delivery

• Infant and child care

• Birth control

• Postpartum care

• Evaluate all clinical reports and refer patient to contracting physicians

• Community health nurse provides follow-up in the home

• Refer routine prenatal patients who develop high risk problems to the private doctor or the High Risk Maternity Clinic for evaluation and follow-up

• Encourage patient to arrange early for hospitalization and to apply for Medicaid for delivery

• All patients will be screened by a Substance Abuse Counselor (when one is available) regarding risk factors concerning substance use and abuse. If the patient is in need of treatment services and willing to participate in treatment, she is referred

Contact: Carol Conrad Rn at 336-242-2311

 

ELIGIBILITY

This program is open to anyone newly diagnosed or uncontrolled diabetic and their caregivers or who has gestational diabetes. The individual may be referred by a physician, other health department personnel, or self-referred.

SERVICES PROVIDED

• Education regarding the dynamics of diabetes and how it can be controlled

• Instruction in the signs and symptoms of hypo/hyperglycemia

• Carbohydrate/diabetic diet instruction using the placemat method

• Discussion of complications of uncontrolled diabetes

• Instruction in use of glucose monitoring device of individual’s choice per order of physician

• Instruction of insulin administration if ordered by physician

Pregnancy Care Management

ELIGIBILITY

Pregnant women living in Davidson County on Medicaid and at risk for poor birth outcomes.

SERVICES PROVIDED

• A public health nurse or social worker will provide care management to Medicaid eligible pregnant women to assure continuity of other needed services (WIC, Food Stamps, housing transportation,etc.)

• Health Educator offers Prepaid Childbirth and Parenting classes to pregnant women.

• Maternity skilled visits will be provided to prenatal patients when the medical provider orders an assessment or treatment.


DISEASE CONTROL

ELIGIBILITY TO ENTER THE PROGRAM

Any individual infected, exposed, or at risk of becoming exposed to a communicable disease.

PERSONS SERVED BY THE PROGRAM

All residents of Davidson County and any other complainant or infected individual.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• Multi-disciplinary EPI-team investigation of communicable diseases.

• Documentation and reporting of findings.

• Disease surveillance for significant differences and/or distribution of cases.

• Report to the Department of Health and Human Services any outbreak investigations.

• Cooperation with other agencies and medical community.

• Enforcement of rules, standards and applicable laws.

• Testing as needed to support diagnosis/investigation.

• Conduct any other field work needed for investigation.

• Provide public education in various forms.

• Investigate complaints of various public health pests such as rodents, birds, insects, etc. capable of causing sickness or injury.

• Provide Blood borne Pathogen training to all new county employees at orientation every other week and on an annual basis for the required employees.

• Provide international travel vaccine consultation and administration of vaccines needed for travel.

• Coordinate and consult with Environmental Health regarding rabies and rabies exposure within Davidson County; provide rabies vaccination clinics for animals; provide human pre-exposure rabies vaccine to veterinarians and their staff, animal control officers, students in the Zoo and Aquarium Science Program at the community college.

• Maintain NCEDSS for all reportable diseases.

ELIGIBILITY TO ENTER THE PROGRAM

Any eligible individual requesting services.

PERSONS SERVED BY THE PROGRAM

All residents of the state of North Carolina.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

Childrens Vaccine Notice

Provide all state required immunizations to children and adults by appointment. Vaccines may be available free of charge through state or federal funds. Vaccines not available through state or federal funding may be administered for a fee. The following vaccines are available:

• Diphtheria, Tetanus, and Acellular Pertussis for children(Dtap) and adults(Tdap).

• Polio(through age 18 years) and also available through private purchase.

• Rubeola (Red Measles),Rubella (German Measles), and Mumps(MMR).

• Haemophilus Influenza Type B Vaccine(HIB) for children.

• Hepatitis B vaccine for children and adults who meet state criteria and private purchase.

• Varicella for children (state supplied) and adults (private purchase).

• Pneumococcal Conjugate Vaccine for children who meet Vaccine for Children Program requirements.

• HPV vaccine for children who are uninsured or underinsured and also available through private purchase.

• Meningococcal vaccines for children who are uninsured or underinsured and also available through private purchase.

• Shingles vaccine for adults (private purchase).

• Hepatitis A vaccine for children (state supplied) and adults (private purchase).

• Yellow fever and typhoid for international travel.

. Typhoid.

. Influenza.

. Pneumonia.

• Rotavirus vaccine.

• Provide information and immunizations for international travel as available and referral for other needed travel immunizations.

. Pre-exposure rabies.

• Provide mass immunizations when required by state or federal government.

• Provide immunization tracking through telephone calls, home visits, letters, etc.

• Provide community education regarding immunizations.

• Relay information to state immunization representative regarding any cases of vaccine preventable diseases.

• Upon request, provide immunization laws to aid school and child care personnel in enforcing immunization law.

• Have available influenza vaccine and pneumococcal vaccine to be administered as per Board of Health guidelines.

• Contractual arrangements are made with agencies that pay for their staff to receive needed vaccines at the health department, i.e., pre-exposure rabies, Hepatitis B, Varicella, etc.

ELIGIBILITY TO ENTER THE PROGRAM

Any individual requesting available services.

PERSONS SERVED BY THE PROGRAM

Any individual requesting available services. Patients are seen in STD Clinic by appointment.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• Screen patients seen in STD, Maternity, and Family Planning Clinics that meet testing criteria.

• Provide free STD clinic for testing, diagnosis, counseling, treatment and/or referral.

• Provide community education to schools, church groups, clubs, etc. regarding STDs.

• Provide outreach and screenings to groups upon request.

• Provide HIV/AIDS counseling, testing and referral.

• Provide referral to HIV support group, case management, and medical services.

• Provide free Hepatitis A and Hepatitis B vaccination to qualified patients.

ELIGIBILITY TO ENTER THE PROGRAM

Any individual requesting services.

PERSONS SERVED BY THE PROGRAM

Individuals receiving services, their relatives and offspring.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

•Provide community education.

•Provide testing and screening for trait or disease.

•Provide counseling for those found to have the trait or disease.

•Refer for financial assistance to appropriate resources.

ELIGIBILITY TO ENTER THE PROGRAM

Persons requesting screening for tuberculosis, TB patients, their families, and contacts.

PERSONS SERVED BY THE PROGRAM

All citizens of Davidson County.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• Provide chest x-rays for patients, suspects and contacts when indicated.

• Provide tuberculin skin testing.

• Provide counseling and obtain a complete patient history.

• Provide sputum examination.

• Perform lab work if indicated.

• Provide medical evaluation and consultation.

• Provide referral to other agencies or physicians.

• Give medication instructions and provide Directly Observed Therapy(DOT) when mandated.

• Maintain NCEDSS (North Carolina Electronic Disease Surveillance System) for tuberculosis patients and patients with Latent Tuberculosis Infection (LTBI).

• Keep up-to-date drug book for all patients on treatment for latent infection.

• Review patient records periodically.

• Provide HIV counseling and testing to all patients known to be a TB suspect/have active TB.

CHILD HEALTH

ELIGIBILITY TO ENTER THE PROGRAM

Newborns residing in Davidson County; services are funded through Medicaid.

SERVICES PROVIDED BY THE PROGRAM

Public Health Nurses assess the infant’s health. They counsel and provide support to parents in the caring of the newborn infant. Based on the assessment, the Public Health Nurse will educate and demonstrate infant care to parent(s). Abnormal medical and social problems will be referred to appropriate resources. This activity is supported by Medicaid.

ELIGIBILITY TO ENTER THE PROGRAM

Children who meet eligibility guidelines (greater than 250% poverty level). Children on Health Choice and Medicaid, which includes Carolina Access, receive well and sick care in the private physicians’ offices and not in the Child Health Clinic.

Age: Birth to 18 years.

Children seen by appointment.

Resident of Davidson County.

PERSONS SERVED BY THE PROGRAM

Children in need and their parents.

SERVICES AND ACTIVITIES PROVIDED

Child examined for normal growth and development, with abnormal findings referred. Nurse screens and evaluates child and family (previous medical history, socio-economic history, and any other pertinent information).

Routine clinic procedures for all children (procedure frequency based on age of child, recommendations for preventive pediatric health care, past history, and nursing judgment)

• Urinalysis as needed

• Blood pressure for ages 3 years and up

• Hemoglobin as needed

• Weight

• Height

• Head circumference on infants

• Administer required and recommended immunizations

• Sickle cell testing when appropriate

• Blood lead level testing when appropriate

• Blood sugar screening, if indicated

• TB skin tests for high risk children

• Vision and hearing screening

• Cholesterol screening and nutritional counseling regarding borderline/elevated levels as needed

• Developmental screening

. Autism screeing if indicated

• Nurse counsels parent/guardian regarding good physical care, nutritional needs, growth and development milestones, emotional needs of child and siblings, and precautions for safety.

• Refer patient to appropriate resources for medical follow-up.

• Instruct family to seek sick child care from private physician.

• Provide clinic education to parents, as well as community education.

• Newborn hearing screening tests on children who do not receive the test at birth, in the hospital, or need a repeat test.

ELIGIBILITY TO ENTER THE PROGRAM

Any child less than three years of age who is at-risk for developmental delay, disability, chronic illness, or social/emotional disorder.

Any child less than five years of age who has a diagnosed developmental delay, disability, chronic illness, or social/emotional disorder.

There are no financial eligibility criteria for the CC4C Program.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

Children may be referred to CC4C by hospitals, private doctors, families, the community, or other providers.

The health department maintains a list of Davidson County children who are receiving Care Coordination for Children from local health departments, Sickle Cell Disease Association, federally qualified health centers, and rural health centers. Health Department Care Managers are Public Health Nurses and Social Workers. They meet with families in the home or clinic environment, as the family chooses.

The Care Manager assesses the child/family’s social, developmental, or medical needs initially and periodically makes appropriate referrals.

The Care Manager works with the family to identify or access appropriate community resources. The primary focus is to encourage or support families in development of the skills needed to solve problems, make decisions, and utilize the human service system.

The Care Manager provides follow up based on needs identified in the assessment and the family’s choices. When children are identified as potentially eligible for IDEA services, the Care Manager proceeds according to the policies specified in the N.C. Infant-Toddler Program manual.

ELIGIBILITY TO ENTER THE PROGRAM

This program is available for any parent, grandparent, baby-sitter, siblings, etc. who has been affected by a SIDS event.

SERVICES AND ACTIVITIES

A public health nurse, who has received special SIDS training, visits with the family to provide counseling, information, and support during their time of grieving and adjustment to the sudden death of their child.

ELIGIBILITY TO ENTER THE PROGRAM

All children under the age of six years are at greater risk from the adverse effects of lead poisoning. Therefore, all children in Davidson County in this age group are eligible to get free screening at the Davidson County Health Department. Private physicians also provide screening services.

PERSONS SERVED BY THE PROGRAM

All of the children in Davidson County in the high risk age group and their families.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• Coordinate activities between the local health department, the Regional Environmental Health Specialist, and the various state agencies, plus local physician offices.

• Provide screening for lead levels in all children less than six years of age.

• Provide educational information to the parents or guardians of the children.

• Initiate a preventive investigation program for lead hazards for the schools in Davidson County, which house children less than six years of age.

• In conjunction with the Regional Environmental Health Specialist, conduct lead hazard investigations in child day care centers where required.

• In conjunction with the Regional Environmental Health Specialist, conduct a lead hazard investigation in any dwelling occupied by a child under six years of age, who has an elevated blood lead level. The health department can also conduct an investigation if it reasonably suspects that a lead hazard exists in a dwelling.

• In conjunction with the Regional Environmental Health Specialists, order abatement or remediation of lead hazards identified in a dwelling, school, or day care facility under the provisions of the statutes and rules.

• In conjunction with the Regional Environmental Health Specialist, review and approve lead abatement plans.

• In conjunction with the Regional Environmental Health Specialists, conduct a lead abatement verification investigation.

• Provide follow-up to all cases with a blood lead level of 10 ug/dl or greater.

• Coordinate medical interventions with private physicians.

ELIGIBILITY TO ENTER THE PROGRAM

Any school age child in Davidson County.

PERSONS SERVED BY THE PROGRAM

Initially, school children and their parents and school staff and ultimately, every citizen in the county.

SERVICES AND ACTIVITIES DESIGNED TO REACH THE GOAL

• School Nurse interprets required immunization needs to teachers and parents.

• School Nurse screens and assesses health issues of children as needed.

• School Nurse screen grades 1,3, and 5 for vision, height, and weight.

• School Nurse counsels students, staff, and parents regarding health problems.

• School Nurse refers children to appropriate resources.

• School Nurse makes home visits for follow-up or counseling with parents and/or children.

• School Nurse acts as coordinator between school, parents, physician, and other community agencies.

• When staff is available, School Nurse teaches classes and works with children, school personnel, and parents on improving nutrition.

• Health Educator is available as a resource person for educational purposes.

• When staff is available, Scoliosis(curvature of the spine) screening is provided to all 6th grade girls and 8th grade boys and girls each school year with parental consent.

• School Nurses will schedule physicals for kindergarten students who are in need financially, at the health department, through the Child Health Clinic.

• Health department staff will be active members of the School Health Council.

• School nurse teaches classes relating to Family Life Curriculum to grades 5-8 as requested by school personnel.

• School Nurse assesses, develops Individualized Health Plans, and provides ongoing evaluation of students with special health needs in the school setting. She teaches appropriate school personnel to perform certain medical procedures that child may need during the school day.

• School Nurse instructs staff about specific chronic health conditions, such as diabetes, asthma, etc.

• School Nurse instructs staff the proper way to administer medications.

• School Nurse instructs students and staff in the prevention of communicable diseases.

• School Nurse continually monitors the safety of the school’s environment for students and staff.