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HomeMy WebLinkAboutMINUTES - 12201988 - 1.52 • r e`. 1 V 1- 052 POSITION ADJUSTMENT REQUEST No. R. " •'Zr Date: 8/22/88 Dept. No./ AUG 2� 9M p Copers � A Department Hlth. Svcs./Pub.lic Hlth. Budget Unit No. 0450 Org. 'NoR803 803 Agency No. 54 ` Action Requested: Classify one (1) 40/14.0 Public Health. Program Specialist I position ("Flag" for PHN) , cancel Public Health. Nurse position #2077. Proposed Effective Date: 1011/88 Explain why adjustment is needed: to properly classify Nurse Epidemiologist position being vacated by B. Benda in Communicable Disease Program. Classification Questionnaire attached: Yes No Q Estimated cost of adjustment: $ (162/tno) Cost is within department's budget: Yes No Q savings If not within budget, use reverse side to explain how costs are to be funded. Department must initiate necessary appropriation adjustment. Use additional sheets for further explanations or comments. f ice for Department Head Personnel Department Recommendation Date: Classify one 40/40 Public Health Program Specialist I position, Salary Level C5 1872 (2952-3589) ; cancel Public Health Nurse position #2077, Salary Level T9 1790 (2930-3751 ) . Amend Resolution 71/17 establishing positions and resolutions allocating classes to the Basic/Exempt Salary Schedule, as described above. Effective: day followin Board action. - -89 Date for Director of Personnel County Admini trator Recommendation Date: pprove Recommendation of Director of Personnel Disapprove Recommendation of Director of Personnel Other: for County Administrator Board of Supervisors Action D E C 2 0 1988 Phil Batchelor, Clerk of the Board of Adjustment APPROVED/ on Supervisor and County Administrator Date: DEC 2 0 1988 - By: APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT. P300 M347 2/85 ACUTE COMMUNICABLE DISEASE CONTROL NURSE EPIDEMIOLOGIST DUTIES AND RESPONSIBILITIES ` TUBERCULOSIS CONTROL 40% In order to promote rapid treatment, contact investigation, new case identification, evaluation for prophylactic treatment, and other measures to control the spread of tuberculosis and prevent outbreaks of TB, the following are duties and responsibilities of the nurse epidemiologist: - Research, develop and write tuberculosis control protocols and policy to be used by personnel in the Health Services Department/Public Health in TB investigation and control. - Review of all newly reported TB cases deciding referral, needed investigation and special control measures needed in individual cases. - Review of TB cases who refuse to follow Public health instructions, developing a plan of action and deciding if legal measures are to be taken. - Give direction and supervision to the TB outreach worker in investigation of all recalcitrant cases. - Decide which additional measures are to be taken with recalcitrant patients by PH nursing and coordinate this follow up giving additional direction, as necessary, to the case PHN. - Review all immigrant chest x ray reports and decide on additional needed follow up or referral. - Determine when a legal order is necessary for a TB case and prepare legal order for issuance by the Health Officer. - Work with other departments (Sheriff, DA, courts) in ongoing monitoring of policy for enforcement of Health and Safety powers and implementation of legal control measures for recalcitrant TB patients. Policy has been developed by all these departments, jointly. - Education of private and public medical community on newest TB treatment and control policy. Give and/or arrange lectures to medical provider on latest information. - Represent county at TB Controller meetings statewide. DUTIES AND RESPONSIBILITIES Page 2 - Act as Public Health representative on TB issues to the private medical community, explaining TB treatment and control policy. - Give direction on TB isolation and interpretation of TB regulations to infection control nurses in the 11 acute hospitals in Contra Costa as well as the nursing homes and board care .homes in this county. - Interpret laws on school admission and screening requirements to all school districts in the county, pre schools and day care centers on TB testing as needed, requested and through routine yearly contacts. - Direct the reporting of all TB cases to the State, after insuring that they are complete and correct, verifying information with the medical provider, through field investigation or through direct patient interviews. - Supervise all activities of the TB registry clerk, statistics clerk and the Communicable disease technician in clerical and reporting duties of TB control. ACUTE COMMUNICABLE DISEASE CONTROL In order to identify disease trends, prevent outbreaks of any of the numerous reportable communicable diseases and to respond to the public need for information and protection in areas of food safety, day care safety and prevention of needless morbidity and mortality the following are duties and responsibilities of the nurse epidemiologist: - Review of all laboratory results for positive tests for communicable disease. Deciding follow up needed and referring to field workers (CD tech, PHN) for needed action. - Give direction, explanation and supervision to field workers on needed investigation measures. Assist in interpreting findings of field investigation and further action plan. Coordinate additional activities in involved cases, such as multiple illness or day care/food worker illness. - Insure that all communicable disease in correctly and completely reported to the State by verifying information with the medical provider, through field investigation or through direct interviews with the patient. DUTIES AND RESPONSIBILITIES Page 3 - Plan and institute special control measures such as special clinics, resturant inspection, day care inspection/closure. Work with Environmental health on resturant closure in extreme cases deciding on length of closure, reopening and disease control measures necessary (testing, removal of certain food handlers) . Direct Environmental Health inspector in special measures or areas of inspection needed in each situation. - Represent Public Health to hospital infection control committees (Kaiser, VA) . Plan and host meeting of all hospital infection control nurses in county as needed. - Represent county at Communicable Disease Controller meetings held bi-monthly for all bay area counties. - Interpret disease statistic for epidemologic trends and report possible disease outbreaks/problems to Public Health director when they occur for needed action such as media notification, Health Officer action and possible request for State assistance. - Insure that all special State report forms are completed and submitted in a timely manner and that the investigator in each case is aware of the special report form needed upon referral. - Determine when food handlers and or day care workers need to be excluded from work to prevent further spread of their illness to the public and issue order for exclusion. Determine through laboratory results and clinical condition, by report of the medical provider, when the exclusion order can be withdrawn and the person may return to work and issue clearance letter. - Respond to public request for information, investigation education on communicable disease conditions by phone contact, lectures, written communication as needed. - Review infection control policies submitted by nursing homes yearly for compliance with State and county regulations on disease control and update as needed. - Advise and give educational lectures to schools and pre schools requesting information on communicable disease. DUTIES AND RESPONSIBILITIES Page 4 - Give direction to schools on special disease situations needing isolation/quarantine instructions, special clinics or informational notices to parents involving meningitis, , hepatitis, childhood illnesses and lice. - Plan and implement special clinics as necessary for specific diseases such as measles and hepatitis. - Direct investigation of nursing homes with special disease outbreak problems, develop action plan for disease control such as isolation/quarantine, immunizations or ongoing inspection until problem is resolved. - Determine if State assistance is needed in outbreak or special disease circumstances and request and direct this assistance after notification of the Public Health Director. - Assist medical providers in update of new disease control information by planning and supervising regular mailing of current information. - Supervise all disease reporting activities of ACD clerk, statistics clerk and CD tech. Give instruction on special forms needed and how to complete these. RABIES CONTROL Rabies remains a life threatening problem in California, in this county each year we have at least 20 animals tested positive for rabies disease. Human contact with wild animals and the subsequent bites which occur remains an ever present problem in Contra Costa. Immediate decisions and action on potential rabies situations is necessary to avoid spread to domestic animals with increase in possible human exposure. In cases where human exposure to wild animals (bites) has occurred immediate and correct action is necessary to prevent death. Additionally, each year many persons are bitten by unknown or unowned domestic animals in this county which often require the same preventive action and decisions, these situations are also handled by this nurse epi. The following are duties of the nurse epidemiologist in the area of rabies control. - Advise Animal control of which animals are to be sent for testing, in response to phone requests from AC. - Review all specimen reports from animal control sent to the Public Health lab and decide (approve/disapprove) which animals are to be tested for rabies. DUTIES AND RESPONSIBILITIES Page 5 - Review all laboratory results on animals tested, decide on action to be taken and: advise bite victim of needed treatment, refer to treatment source, advise pet owner of domestic pet in contact with wild animal of needed action (quarantine, sacrifice of pet etc) . Relay these instructions to Animal control for needed action. - Instruct medical providers on current rabies treatment protocol and risk of specific situations when requested. Assist patient and medical provider in determining risk of specific situation, need for treatment and where to obtain treatment in the county. - Administer pre exposure rabies vaccine to all new Animal control and PH laboratory personnel. Determine need for post exposure treatment in the case of exposure of these personnel. - Represent county at State Rabies control meeting yearly. - Direct and insure all reporting of rabies cases to State. ADDITIONAL RESPONSIBILITIES INCLUDE: - Back up for Immunization Program coordinator giving information on immunizations, safety, disease control and legal requirements for school entry. - Back up for Director of CD Control of disease control issues answering calls from general public and other duties assigned to the CD Controller. - Work as part of flu clinic staff giving injections and screening patients for immunization safety. - Screening Animal Control officers and Laboratory peronnel for needed immunizations, including Hepatitis B and Rabies, and giving these immunizations. - Screening Public Health personnel for needed immunizations, including tetanus and Hepatitis B and administering these immunizations as well as screening tests for TB.