Department of Health
Michael C. Caldwell, MD, MPH, Commissioner
At Your Fingertips:
Dutchess County Department of Health
PUBLIC HEALTH SERVICES
and
REPORTING REQUIREMENTS
Find available Public Health Services offered by DCDOH and Reporting Requirements by clicking on any of the following titles:
- Communicable Diseases
- Early Childhood Development (Child Find and EIP)
- Emergency Preparedness
- Immunizations
- Laboratory Consultation for Communicable Diseases/BT Exposures
- Lead Poisoning
- Maternal Health Services
- Office of the Medical Examiner
- Rabies
If you do not have internet access, call (845) 486-3421 and we will mail you the materials.
Consultation Patient Location and Treatment Compliance REPORTING Diseases listed in red/bold/underlined in Table 1 must be reported by phone or fax, followed by submission of form DOH-389. DOH-389 (.pdf) forms are available by calling (845) 486-3401. Specific sections of this guide have been devoted to the public health services provided by DCDOH and the necessary reporting requirements for the following communicable diseases: Table 1 (Table 1 in .pdf format) By statute (10 NYCRR 2.10A), effective 08/2000, the following must be reported to the DCDOH within 24 hours. Diseases in bold must immediately be reported by telephone or fax and followed by submission of Form DOH-389 (.pdf). + Animal Bites - Health care providers must immediately report suspected rabid animals and persons exposed to them to the Environmental Health Services Division, DCDOH at (845) 486-3404. The full name, age, address and telephone number must be provided of any person under care, observation or who has been exposed to any animal suspected of having ++ rabies. All pertinent facts relating to such exposure must be provided. ++ Syphilis - Report by phone any non-treponemal test ≥1:16 or any positive prenatal or delivery test regardless of titer; all others may be reported by mail. Confidential and Anonymous HIV Counseling and Testing Partner Services Program (845) 486-3452 REPORTING HIV/AIDS Reporting Cases should be reported using both of the following forms: DO NOT report HIV/AIDS directly to DCDOH. SEXUALLY TRANSIMITTED DISEASE (STD) PUBLIC HEALTH SERVICES Effective prevention of disease transmission begins with infections that are properly diagnosed, appropriately treated and fully reported to the local health unit in a timely and complete manner in accordance with the established laws and regulations. REPORTING For reporting the sexually transmitted diseases listed below utilize the DCDOH Sexually Transmitted Disease Reporting Form (.pdf). These forms are available by calling (845) 486-3401. COMMUNICABLE DISEASE: TUBERCULOSIS (845) 486-3505 PUBLIC HEALTH SERVICES Treatment for Active TB and LTB1 Directly Observed Therapy (DOT) Mantoux Skin Test Clinics REPORTING Tuberculosis reports should be called in to (845) 486-3505.
COMMUNICABLE DISEASES (845) 486-3401
PUBLIC HEALTH SERVICES
DCDOH offers consultation regarding screening, diagnosis, treatment, follow-up and referral as part of their disease reporting, intervention, surveillance, and education activities. Assistance is available in areas such as accessing laboratory services, confirming diagnoses, recommending prophylactic measures for family members, and offering isolation and quarantine guidance.
Assistance is available for patients with certain communicable disease(s).
Physicians must report confirmed cases of communicable diseases listed in attached Table 1 (.pdf) to the DCDOH within 72 hours. Those listed in red/bold/underlined require immediate reporting.
Phone #:
(845) 486-3401 (Monday – Friday 9 – 5)
After Hours Phone #:
(845) 431-6465
Fax #:
(845) 486 –3564
Mailing Address:
DCDOH Att: CDCD 387 Main St. Poughkeepsie, NY 12601
Physicians should also report by phone:
Amebiasis
Animal bites for which rabies
prophylaxis is given+
Anthrax
Babesiosis
Botulism
Brucellosis
California Encephalitis
Campylobacteriosis
Chancroid
Chlamydia trachomatis
Cholera
Cryptosporidiosis
Cyclosporidiosis
Diphtheria
E. Coli 0157:H7
Eastern Equine Encephalitis
Ehrlichiosis (HGE,HME)
Encephalitis
Food borne illness
Giardiasis
Glanders
Gonorrhea
Haemophilus Influenza
Hantavirus
Hemolytic Uremic Syndrome
(HUS)
Hepatitis A (HAV)
Hepatitis A in a food handler
Hepatitis B (HBV)
Hepatitis C (HCV)HIV
Legionellosis
Listeriosis
Lyme Disease
Lymphogranuloma venereum
(LGV)
Malaria
Measles
Meiliodosis
Meningitis (Aseptic & Viral)
Meningitis (Haemophilus)
Meningitis (Meningococcal)
Meningitis Other (specify type)
Meningococcemia
Monkey Pox
Mumps
Pertussis
Plague
Poliomyelitis
Powassan Viral Encephalitis (POW)
Pregnant Hepatitis B infection
Psittacosis
Q Fever
Rabies
Rocky Mountain Spotted Fever
Rubella (including congenital rubella syndrome)Salmonellosis
SARS
Shigatoxin-producing infection
Shigellosis
Smallpox
St. Louis Encephalitis
Staphylococcal Enterotoxin B Poisoning
Staphylococcal Aureus
Streptococcal Infection (Group A beta-hemolytic strep)
Streptococcal Infection (Group B strep)
Streptococcal Infection (Invasive disease)
Streptococcus pneumoniae
Syphilis (specify stage) ++
Tetanus
Toxic shock syndrome
Trichinosis
Tuberculosis
Tularemia
Typhoid
Vibriosis
Viral Hemorrhagic Fever
West Nile Virus
Yellow Fever
Yersiniosis
COMMUNICABLE DISEASE: HIV/AIDS (845) 486-3401
PUBLIC HEALTH SERVICES
Confidential and Anonymous HIV Counseling and Testing is provided. DCDOH offers HIV counseling and testing at walk-in clinics at 387 Main St., Poughkeepsie on Mondays from 1:00 to 3:00 and by appointment. Please call (845) 486-3401 to schedule an appointment.
DCDOH assists HIV-infected patients and their health care providers in contacting persons who may have been exposed. DCDOH will attempt to notify and counsel contacts regarding their potential exposure. Field testing is a component of partner notification service. Training is also available for healthcare providers.
As of June 2000, HIV infection became reportable. Upon initial determination that a person is infected with HIV or upon initial diagnosis that a person has AIDS or HIV-related illness, physicians and laboratories are required to report the person’s name to the AIDS Epidemiology Program listed below. The patient’s name will remain confidential.
AIDS Epidemiology Program
PO Box 2073
ESP Station
Albany, NY 12220
Telephone: (518) 474-4284
COMMUNICABLE DISEASE: (845) 486-3401
Sexually Transmitted Disease Partner Notification
To achieve maximum disease intervention, a Public Health Advisor will conduct a STD interview/counseling session without delay after the confirmed infection is reported to DCDOH. The rationale for this activity is:
The sexually transmitted diseases listed below should be reported by:
Phone:
(845) 486-3401. After hours messages can be left at (845) 486-3452
Fax #:
(845) 486–3564 and/or
Mail to:
DCDOH Att: CDCDC 387 Main St., Poughkeepsie, NY 12601
The DCDOH provides free chest X-rays, physician exams, medication and lab work for persons with LTBI or active TB who are uninsured or under insured at the monthly pulmonary clinic, by appointment.
Currently the standard of care, Directly Observed Therapy is available for all cases of tuberculosis. DOT is also provided free of charge for patients diagnosed with LTBI who are determined to be at high risk for non-compliance. Included in the standard of care for all active cases is to provide DOT free of charge.
Free walk-in clinics are available: Mondays (except holidays) at DCDOH, 387 Main Street, Poughkeepsie from 1:00 pm to 3:00 pm. Persons tested must return for reading on Thursday of the same week at the 1:00 pm- 2:00 pm.
It is a requirement of New York State Sanitary Code that all suspects and active Tuberculosis cases be reported within 24 hours. Tuberculosis reports are mandatory if any of the following criteria are met:
After-hours - (845) 431-6465.
PUBLIC HEALTH SERVICES Patient Follow-up Physicians may request assistance from Public Health Nurses to encourage compliance with immunization schedules. Professional Consultation Under the Provider Based Immunization Initiative (PBII), DCDOH will review a medical practice’s immunization procedures and offer suggestions for increasing immunization rates. Program is voluntary. DCDOH can provide the latest information on recommended immunization practices. DCDOH provides the following Immunization Clinics: Children’s Immunization Clinics Children’s Immunization Clinics are held monthly throughout Dutchess County. All routinely recommended immunizations are offered. Records of previous immunizations must be brought to the clinic. To be eligible to attend these clinics children must be 18 years of age and younger. Children 17 years of age or younger must be accompanied by a parent/guardian. There is no fee for this service. For dates and times of clinics call (845) 486-3409. Adult Immunization Clinics Adult Immunization Clinics are held twice per month for recommended adult immunizations. No appointment is necessary. There is a fee for this service. The clinic is located at DCDOH 387 Main Street, Poughkeepsie. For dates and times of clinics call (845)-486-3409. Immunization for International Travel Immunization and health advice are offered at clinics held twice per month. Clinics are by appointment. A wide range of vaccines including hepatitis A, hepatitis B, meningococcal meningitis, yellow fever, and typhoid are available. There is a fee for this service. The clinic is held at DCDOH 387 Main Street, Poughkeepsie. For more information and to schedule an appointment call (845) 486-3504. Influenza and Pneumonia Immunization Program Influenza and pneumonia immunization clinics are held throughout Dutchess County during October and November. Immunizations are offered to adults at high risk for complications following influenza, and adults at greatest risk for transmission of disease to persons at high risk. Medicare Part B is accepted as payment. The clinic schedule is published in the Poughkeepsie Journal in September and is available by calling the Influenza immunization hotline number at (845) 486-3435.
IMMUNIZATIONS (845) 486-3409
PUBLIC HEALTH SERVICES Child Find Child Find is to ensure that infants and toddlers at risk of developmental delays and disabilities are identified and have their development monitored. Public Health Nurses educate parents and make referrals to community services including EIP. Early Intervention Program (EIP) The Early Intervention Program (EIP) helps children up to age 3 who have developmental delays or disabilities. It provides evaluation, service coordination, special instruction, speech, occupational, and physical therapy, and other services. Insurance is accessed, but families are not charged. REFERRAL Child Find Referral 845-486-3419 Referrals to Child Find should be made for infants and toddlers with any of the risk factors listed below. - Neonatal - - Post-neonatal / Early Childhood - - Additional Risk Criteria - Early Intervention Referral (EIP) (845) 486-3518 With parents’ permission, physicians should refer infants and toddlers from birth through age 2 who are suspected of having a disability, developmental delay and/or diagnosed physical or mental condition that has a high probability of resulting in a developmental delay (as listed below). Starting at about 2 years 6 months children should be referred to their school district’s Committee on Preschool Special Education. Referrals to EIP should be made within 2 working days when any of the following conditions are present:
that Should Be Referred to Child Find
If the parent prefers to self refer or if parent objects to a physician referral, the physician should give the parent the above phone number of EIP. Physician’s office should follow up with the parent within two months to seek to refer the child.
Dutchess County has a comprehensive plan, entitled Health Emergency Response Plan, to help prepare the community for possible public health emergencies, including those caused by natural or intentional emergencies. While the memories of September 11th and the anthrax scares are fading, the chances of such intentional attacks have not diminished. Healthcare providers play an important role in detection and response to a public health emergency. An early detection of a cluster or an unusual illness will likely present first at the doorsteps of a healthcare provider. An alert provider would be the first to inform the health department, giving an early start to the investigation process. Steps to Healthcare Provider Preparedness: As a healthcare provider the following steps can help you to be better prepared:
http://www.co.dutchess.ny.us/CountyGov/ESbioterrorlinks.htm
Example: “HPN Request, John Smith, MD, Dutchess County.” Include the following information in your email: Your full first name (DO NOT use nicknames), full middle name (not just the initial), and full last name. (For example: Elizabeth Ann Doe); your date of birth; your direct office telephone number; your office fax number; your direct e-mail address; and your mailing address.
Communicable Disease or Suspect BT Exposures Private physicians are strongly encouraged to consult with DCDOH at the above telephone number regarding the collection, processing and shipment of: Bacteriologic and viral specimens for such agents as West Nile Virus, Salmonella sero-typing, e coli 0157 confirmation and others will be referred to the NYSDOH Wadsworth / Griffen Labs for confirmation. Clinical and environmental suspect bio-terrorist agent samples will be referred to Westchester Medical Center Level 3 laboratory.
LABORATORY CONSULTATION SERVICES (845) 486-3401
PUBLIC HEALTH SERVICES Elevated Blood Lead Levels Public Health Nursing will provide the following services: Environmental Health Services will provide the following services:
REPORTING Elevated Blood Lead Levels All children with a confirmed venous BLL greater or equal to 15mcg/dL to receive environmental management services. Venous confirmation is required of all BLL greater than or equal 10mcg/dL. New regulations impact all children up to age eighteen years of age. All children under the age of eighteen who have a BLL greater than or equal to 45 mcg/dL, must be reported to the Dutchess County Department of Health with in 24 hours of laboratory notification.
LEAD POISIONING (845) 486-3419
PUBLIC HEALTH SERVICES Assessment, Support & Coordination Physicians may request Public Health assessment and follow-up for pregnant women, mothers, and young children who are at risk. Risks include: Maternal/Child Home Visiting Home visiting services include: Children in Foster Care The Department of Social Services refers all foster care children under the age of 3 to Public Health Nursing for developmental surveillance. This surveillance program ensures the healthy development of foster care children and support foster care families. Newborn Screening Each newborn in New York State is tested for metabolic diseases, HIV infection and hearing. NYSDOH and local hospitals refer those newborns that have positive or incomplete results to Public Health Nursing for follow-up. The Public Health Nurses locate these families and arrange for re-testing and medical follow-up.
MATERNAL/CHILD HEALTH SERVICES (845) 486-3419
Mother
Child
• Age 16 or under
• Poor nutrition
• Low birth weight
• Mental illness or retardation
• Lack of parenting, coping skills
• Diagnosis requiring nursing follow-up
• Poor prenatal follow-up
• Post-partum depression
• Under 32 weeks gestation
• HIV positive
• Substance abuse
• Asthma
• Physical difficulty affecting parenting
• Lack of support system
• Inborn metabolic disease
• Known fetal anomaly
• Child-Protective involvement
• Immunization delays
• Gestational diabetes
• Preeclampsia
• Failure to thrive
(24 hours a day, 7 days a week) JURISDICTION IN DEATH INVESTIGATIONS The Office of the Medical Examiner has jurisdiction and authority to investigate the death of any person who dies within the County of Dutchess, or whose body is found within the County under the following circumstances: REPORTING All deaths occurring under the above mentioned circumstances should be reported promptly to the Office of the Medical Examiner at (845) 431-9177, 24 hours a day, 7 days a week and a Medico-Legal Investigator (MLI) will respond to the call. AUTOPSY POLICY The Office of the Medical Examiner will perform an official autopsy in any death resulting from homicidal violence, criminal negligence, suicide, fire, asphyxia, vehicular and other accidents, drugs or chemical overdose, when a death is unexplained, when a death occurs in police custody or legal detention, and whenever an autopsy is deemed necessary in the interest of public health and safety. The need for an autopsy in the evaluation of a sudden, unexplained death apparently due to natural disease is decided on an individual basis. The MLI will make arrangements for transfer of the decedent to VBMC mortuary.
OFFICE OF THE MEDICAL EXAMINER (845) 431-9177
The following information will be requested of the person reporting the death:
An objection to autopsy based on religious beliefs will be honored, except in cases of homicide, or when public health is at stake. Objections to autopsy for personal reasons will be considered on an individual basis.
PUBLIC HEALTH SERVICES Consultation & Investigation Physicians are required to consult with the DCDOH before initiating rabies post-exposure treatment. The DCDOH is available 24 hours a day, seven days a week to evaluate a contact between a human and a potentially rabid animal and to authorize post-exposure treatment. During normal business hours (Monday through Friday, 9 am to 5 pm), the DCDOH can be reached at (845) 486-3404. On weekends, holidays, and after hours, the DCDOH can be reached at (845) 431-6465. The DCDOH will oversee animal observation and testing and has the expertise to assess the likelihood of rabies exposure, whether or not the suspect animal is available. As part of its investigation, the DCDOH will also determine whether other people or domestic animals were exposed to the rabid or potentially rabid animal. When rabies post-exposure treatment is indicated, the DCDOH will monitor to assure that all appropriate rabies biologics have been properly administered and completed. Pre-Exposure Vaccination DCDOH offers pre-exposure vaccination against rabies for persons in high-risk occupations. Information On request DCDOH can provide informational brochures. REPORTING Health care providers are required to immediately report to the DCDOH any patient exposed to a potentially rabid animal (click here for the Suspected Rabid Animal or Rabies Exposure Report form). Rabies vector species (bats, skunks, raccoons, and foxes) and domestic animals (such as dogs, cats, and ferrets) are considered suspect. Other animals that exhibit abnormal behavior, clinical signs of rabies, or that attack unprovoked are also considered suspect. Exposure Definition
RABIES (845) 486-3404
Up to 72 hours can be safely spent searching for a dog or cat that has bitten someone before starting post-exposure treatment. When warranted, DCDOH organizes applicable searches.
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County Executive