COMMUNICABLE DISEASE BUREAU

PROGRAM MISSION: To prevent the spread of communicable disease through prevention, detection, education and outreach in the community.

• The Disease Surveillance and Investigation Program seeks to limit transmission of reportable communicable diseases (such as hepatitis, meningitis and SARS) in the community, as mandated by Virginia State law. Strategies include ongoing community surveillance and prompt response to reports of communicable disease. Education, outreach, and consultation are provided for individuals, community groups, work-sites, schools and daycare providers. The Shelter Liaison public health nurse prevents the spread of communicable disease among homeless individuals, families and shelter staff by identifying communicable diseases and instituting control measures in County shelters. The Refugee Program within the Communicable Disease Program prevents or minimizes the spread of communicable disease and long term chronic illness in people newly arrived in the United States through federal refugee programs.

• The HIV/AIDS and Sexually Transmitted Diseases Program prevents infection and transmission of human immunodeficiency virus (HIV) and sexually transmitted disease (STDs), and provides consultation, testing, referral and treatment for STDs and HIV/AIDS medication services. The major components to the program are testing and counseling, community education and outreach for HIV and STD.

• The Chest Clinic/Tuberculosis Control Program limits transmission of tuberculosis by identification, assessment, monitoring and treatment of individuals with infectious disease and those exposed to tuberculosis in Arlington County. The program provides tuberculosis education and consultation to community members and the medical community.

• Emergency Preparedness Planning, a priority in the Communicable Disease Bureau since the events of 9/11, continues to require a significant commitment of the Bureau. A public health emergency preparedness planner, an epidemiologist and public health nurses closely monitor, on a daily basis, emergency room visits and hospital admission data to detect suspicious patterns of disease; make frequent contact with community physicians and laboratories for early indications of bioterrorism activity; and are actively engaged in multiple local, regional and state planning and response activities. These activities strengthen the capacity of the Bureau and Division to meet the demands of all communicable disease threats to the community.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Non-Personnel increased ($45,509) for Medical Reserve Corp Grant ($50,000), partially offset by reductions in maintenance agreements and equipment rental in anticipation of the move to the Fenwick Center.

• Nonprofits include additional funding for Whitman-Walker Clinic for case management services ($60,000) and operating expense increases ($865).

• Fee revenues increased ($7,000) based on FY 2004 actual collections and FY 2005 anticipated collections.

• Medicaid and Medicare revenue are both reduced based on prior year collections.

• Revenues increased ($12,000) in the Refugee program to reflect amount collected in FY 2003 and FY 2004, and anticipated collections at a recently approved rate increase.

• State Share increased ($19,136) to reflect Virginia Department of Health Cooperative funds increase effective in FY 2005.

• Miscellaneous Grants reduced ($44,500) to reflect loss of Targeted Tuberculosis in Children grant.

• Federal grants increased ($73,225) due to the Medical Reserve Corp Grant ($50,000) and increases in Bio-Terrorism and Tuberculosis Outreach Grants.

• FTEs decrease (0.8 FTE) due to loss of a grant funded Public Health Nurse for the Targeted Tuberculosis in Children grant.

PERFORMANCE MEASURES:

Disease Surveillance and Investigation Program

• Significant workload increases have been experienced due to intense disease surveillance involving monitoring of emergency room visits, hospital admissions, community physicians, and frequent contact with laboratories resulting from bioterrorism threats.

Refugee Clinic

• The Virginia Department of Health has established a goal of 95% for the percent of new refugees medically screened within 30 days (if not screened elsewhere).

• A new refugee has come directly to Arlington from his or her country of origin. A secondary refugee comes to Arlington after spending time elsewhere in the United States.

HIV/AIDS and Sexually Transmitted Disease Program

• Rates for Syphilis, Gonorrhea and HIV are reported annually, by calendar year, consistent with Virginia Department of Health data. CY 2002 rates reflect a decrease from the previous year.

• During FY 2004, the Bureau lost the CDC Aids Minority Grant and a Health Educator position.  This was the AIDS Minority Health Educator role.  Beginning in July 2004, we decreased prevention work in the community.  Thus, the decrease to 83 presentations.

Chest Clinic/Tuberculosis Control Program

• Collection of patient satisfaction surveys will begin in May, 2005.

• TB cases are mostly foreign born.