I.
Administrative Services
The Health Officer functions as the chief administrative officer to the Madison Board
of Health and manages the general activities of the Health Department in accordance to New
Jersey States Annotated Title 26. The Health Officer, as authorized by the Madison Board
of Health, is the Health Department's Departmental Head and is the responsible agent for
all public health services and activities of the Madison Health Department. As the
Departmental Head, it is the Health Officer's duty to:
1. Direct and supervise all employees of the Health Department.
2. Plan, manage and implement the Public Health Programs of the Health Department.
3. Prepare and manage the Health Department budget.
4. Maintain administrative relationships and communication with support services and
community resources such as hospitals, emergency medical services providers, government
agencies, voluntary organizations and other health care providers to promote inter-agency
cooperation and effective allocation of health resources.
5. Enforce all public health laws, regulations and ordinances and ensure appropriate
disposition of all enforcement action.
6. Provide for open lines of communication within the organization.
7. Develop and maintain a referral directory for health services provided by other
agencies to community residents.
8. Determine and define the health needs and priorities of the community based upon
analyses and interpretation of health statistics and other pertinent information.
9. Maintain proper records in accordance with the local health agency records retention
schedule.
10. Develop and present to Madison's contracting communities the interlocal agreements
to provide health services.
11. Develop and maintain a departmental policy and procedure manual.
12. Develop and present to the Madison Board of Health and the State Health
Commissioner an annual written report of the entire public health program.
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II.
Environmental Health Services
A. Retail Food Establishment Surveillance
The Health Department's Health Officer and two Sanitary Inspectors conduct an on-site
Retail Food Establishment inspection and surveillance program based upon State Laws and
regulations, including Chapter 12 of the State Sanitary Code and local ordinances. This
inspection and surveillance program includes all of the Retail Food Establishments (RFE's)
within the Borough. Retail Food Establishments can include restaurants, food markets,
taverns, liquor store, roadside stands, catering kitchens, industrial kitchens, private
clubs, and non-profit kitchens.
As per the State Code, inspections shall be conducted at least once yearly. An
"inspection" includes the initial inspection and all necessary follow-up
inspections. The Madison Health Department has made it an unwritten policy to inspect the
ninety-nine RFE's at least twice yearly. When deemed necessary by the Health Officer,
certain RFE's may be inspected three or four times yearly.
Further comprehensive surveillance includes maintaining up to date files on each
establishment, initiating appropriate enforcement action to secure compliance with State
law and local ordinances, assisting the State Health Department with follow-up of
food-borne illnesses, collecting food samples and providing for laboratory analysis of any
food suspected of being associated with a food-borne illness, assisting the State Health
Department in conducting recalls of foods found to be contaminated, embargoing all food
known or suspected of being adulterated or unwholesome, and supervise the destruction of
all adulterated or unwholesome food. A routine inspection requires the services of only
one Health Officer or Sanitary Inspector. Other surveillance measures may require the
concurrent action of all three employees licensed to perform these duties. These
inspections and surveillance measures are performed in Madison's retail food
establishments and are conducted to ensure the health and safety of Madison's general
population.
B. Recreational Bathing
The Health Department's Health Officer and two Sanitary Inspectors conduct a sanitation
and safety program at public bathing places, based upon the current "Recreational
Bathing" regulations contained in Chapter 9 of the State Sanitary Code. This
sanitation and safety program includes all the public bathing places within the Borough.
Public bathing places can include swimming pools, lakes and spas.
As per the State Code, each bathing place shall be inspected at least twice per year.
Follow-up inspections and enforcement actions are conducted as necessary. Water quality
monitoring is performed throughout the bathing season. Infectious disease outbreak
investigations and consumer complaint investigations are conducted as necessary.
C. Youth Camps
The Health Department's Health Officer and two Sanitary Inspectors conduct a youth camp
sanitation and safety program. This sanitation and safety program includes all of the
youth camps within the Borough. A youth camp is a parcel of land or a building having the
general features of a camp that is used wholly or in part for recreational or educational
purposes and accommodating five or more children under 18 years of age for a period of at
least two days. It also includes sites that are operated as day camps.
D. Public Health Nuisance Abatement
The Health Department's Health Officer and two Sanitary Inspectors conduct a public
health nuisance abatement program. This abatement program will be based upon various State
laws and local ordinances. It will include the investigation, monitoring and abatement of
health nuisances such as: noise, noxious odors, weed overgrowth, water pollution, solid
waste, property maintenance, improper storage of garbage and garbage receptacles, improper
storage of firewood, pest control, animal control, and dumping of solid waste.
The successful completion of a health nuisance investigation entails a phone
conversation or personal interview with the complainant, repeated visits to the site of
the violation, issuance of a violation letter to the responsible party, and follow-up
legal action when needed. A comprehensive health nuisance abatement program includes
maintaining an up to date filing system on all actions taken in each case.
E. Lead Paint Environmental Investigations
The Health Department's Health Officer and two Sanitary Inspectors conduct
environmental investigations, in accordance with Chapter 13 of the State Sanitary Code,
whenever a child in Madison is determined to have an elevated blood lead level or lead
toxicity. An investigation is conducted to identify lead sources in the child's
environment. If the results of the environmental investigation reveal any loose paint, a
determination of lead content of the painted surface in the suspected areas is made by the
Sanitary Inspector or the Health Officer. If the paint in the suspected areas is found to
be leaded, the Sanitary Inspector or Health Officer monitors the safe removal of the
leaded paint. This is done according to the procedures found in N.J.A.C. 8:51-5, Standards
for Repair on Premises Containing Lead Paint.
F. Multiple Housing
The Health Department's Health Officer and two Sanitary Inspectors conduct an
inspection and violation remediation program for all Madison dwellings with three or more
apartments. This inspection and violation remediation program is based on N.J.A.C. 5:10,
Maintenance of Hotels and Multiple Dwellings Regulations.
An inspection of a multiple dwelling is usually initiated when a citizen complaint,
regarding that building, is registered with the Health Department. Every multiple dwelling
in Madison, even in the absence of citizen complaints, is inspected at least once every
five years. To initiate the process, the landlord is notified by certified mail that the
Health Department needs physical access to every unit in the building to be inspected. The
Health Officer/Sanitary Inspector then makes as many visits as necessary to the dwelling
to complete the initial inspection.
Before an initial inspection is considered complete, entry to every unit of the
building must be gained. One or more follow-up inspections are necessary to ensure
remediation of violations. Appropriate enforcement action is taken to assure timely action
by the landlord.
G. Pet Shops, Pounds, and Kennels Inspections, Unlicensed Pet Follow-up and
Disease Outbreak Investigations
The Health Department's Health Officer and two Sanitary Inspectors conduct various
inspections and investigations to prevent disease outbreaks within the animal population
of Madison. Pet shops, pounds and kennels are each inspected once annually by the Health
Department. The Health Department is also responsible for investigating infectious disease
outbreaks involving these facilities. It also follows up on unlicensed dogs and cats that
are reported by the municipal pound. A follow-up entails checking the Health Department's
licensing files and taking legal action should the animal be unlicensed.
H. Rabies Control
The Health Officer or Sanitary Inspectors investigate animal bite incidents. The
offending animal's records are reviewed, it is placed on quarantine and released ten days
later. If the animal has been euthanized, the specimen is transported to the State Health
Department Laboratory in Trenton for analysis. If the specimen is found to be positive for
rabies, it is the responsibility of the Health Department to notify everyone who has been
exposed to this animal. A Rabies Post-exposure Report must be completed for each person or
animal who has been exposed to the rabid animal.
I. DEPE Referrals and Investigations
The Health Department's Health Officer and two Sanitary Inspectors provide follow up
investigations and general assistance for the NJ Department of Environmental Protection
and Energy. These investigations and assistance can involve chemical spills and releases,
underground storage tank installations, air pollution, solid waste dumping, cancer
clusters, ground water pollution, and stream pollution.
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III.
Personal Health Services
A. Child Health Conferences
The Health Department's Part-time Nursing Director and Part-time Public Health Nurse
conduct child health conferences, a service that is targeted at Madison's infant and
pre-school population. Child Health Conferences are professional services offered to
infants and pre-school children, whose parents may not otherwise have this service
available to them. This service includes a physical examination by a physician, evaluation
of growth and development, immunizations, hemoglobin and tuberculin screenings,
nutritional guidance, referral, instruction in safety and parenting, and community
resource information.
Through state and municipal funding, these services are provided at no cost to the
client in an effort to provide safe and healthy children and families. The service is
offered once a month on the second Wednesday at the Madison Civic
Center., 28 Walnut Street.
The clinic involves registration and interviewing the parent prior to scheduling,
assessment of proper immunizations, set-up of screening equipment, emergency equipment,
testing and evaluation tools and an immunization station. Educational hand-outs, and
instruction are also pre-arranged. To provide these services, there is a pediatrician and
two public health nurses per clinic.
Following the clinic, precise recording procedures are maintained to meet state
statutes regarding immunizations and visits. Timely follow-up appointments are arranged.
B. SMAC Testing
To optimize the health of Madison residents, clinics, featuring a multi-parameter blood
test called a SMAC, are conducted by the Health Department's nursing staff
three times a
year. This test, which is
available to all is used in detecting cardiovascular disease, diabetes, and kidney disease
by measuring cholesterol, triglycerides, glucose, and creatinine. Madison residents over
age 18 may attend every year. There is a fee of $25.00. Services are provided with
Accumed Diagnostic Laboratory on-site at the Madison Civic Center. In addition to the Blood test, hypertension
screening is done by the public health nurses, and the health educator is on hand to do
computerized Health Risk Appraisals.
After the clinic, written and computerized results are sent to the client and to their
personal physician, and files are maintained in the Health Department.
Similar services are provided at least yearly for other contracting towns in their
respective locations.
C. Cancer Screenings
In an effort to diagnose cancerous conditions in their earliest and most treatable
condition, the Madison Health Department's nursing staff conducts screenings twice yearly
for both men and women. To optimize healthy lifestyle choices, residents are
taught and given educational materials to inform them of the risks associated with
different cancers and the measures to help prevent cancer from beginning. Clinics are held
in the spring and fall at the Madison Civic Center.
Women receive a breast exam, a gynecologic exam and rectal exam. Instruction on monthly
self-breast examination is offered and mammogram coupons are available. A pap test is done
by the gynecologist during the exam and the specimens are sent to
Accumed Diagnostic Laboratory.
Blood pressure screening is also done. On hand to perform these services are two to three
public health nurses, a gynecologist, health educator, and secretary for registration and
file set-up. The fee is $30.00 for Madison residents.
Men receive a prostate exam, a rectal exam and exam for breast cancer. Blood pressure
screening is also done. Age appropriate, instruction on testicular self-examination is
also given. The Prostrate Specific Antigen (PSA) blood test is done at the patients
request for a fee of $30.00. All other services are offered at no charge. A male medical
doctor performs the examination, a public health nurse runs the clinic and does blood
pressure screening, and the secretary assists with registration and files. The health
educator also provides instruction.
D. Influenza Immunization Clinic
To prevent the incidence of disease by influenza in the elderly and the
chronically-at-risk individuals, flu shots are administered seasonally by the Madison
Health Department to the residents of Madison. There is no charge for these
services to people 62 years and older. The Health Department is reimbursed by Medicare
for those who are eligible.
A doctor and four public health nurses are present at the two flu clinics to administer
the immunizations to the high volume of people on a walk-in basis.
E. Hypertension Screening
To assist Madison residents in detecting early signs of hypertension and to aid in
monitoring this cardiovascular disease, the Madison Health Department provides screening
on the second Friday of every month at the Health Center. One or two public health nurses
provide this service. In both cases, the service is offered twelve times a year. Education
is provided to help citizens adapt healthy lifestyle patterns. Although this service is
targeted at the elderly, all Madison residents are encouraged to attend.
F. Communicable Disease Reports
To provide for the safety and optimal health of the citizens within its jurisdiction,
the Madison Health Department through its health officer and public health nurses,
investigates cases of communicable diseases to determine the extent of its spread. The
Health Department must also ensure that proper treatment was received and measures were
taken so that the public is not at risk as a result of the contagion. These reports are
sent to the office, often on a daily basis, from laboratories. Investigations and
follow-up reports are then routed to doctors, local health departments, and the State
Health Department to the Communicable Disease Control Services. Education is also provided
to the public and health-care providers regarding the management of these communicable
diseases. In addition to the public health nurses, the sanitarians play a valuable role in
many of these investigations by assisting with phone surveys and transportation of
specimen containers.
G. School Audits
In an effort to protect the health status of its residents from epidemic proportion of
communicable diseases which can have serious consequences, in some cases even death, the
public health nurses audit age-level-appropriate vaccinations and immunizations for
pre-school, day care and school-age populations at their centers and schools. This service
requires on-site visits to 13 public and private institutions, twice at most places. As
many as 200 records are audited in individual settings. Education is also a major
component to providers to be certain that they are aware of current State requirements.
Usually two public health nurses make these on-site visits and necessary follow-up visits.
Documentation of the findings are then forwarded to the State Health Department.
H. Tuberculosis Investigations
The public health nurses work in the community to complement the work of the Morris
County Tuberculosis Service located in Morristown Memorial Hospital. These services
include identifying and testing possible cases of tuberculosis and referring them for
confirmation and follow-up services. Investigation of contacts is done as required.
Mantoux testing is given free of charge to teachers and personnel who are working with
children and high-risk groups. Mantoux tests are also given to children for screening
purposes as part of Child Health Conferences. These services are provided on-going as
requested. Arrangements have been made with the State Health Department to receive
supplies and vaccine at no cost.
I. Lead Risk Assessments
To determine if the children of Madison are being exposed to the hazards of lead
contaminated peeling paint or lead contaminated dust, the Health Department's nursing
staff conducts lead screening assessments on children when they attend the Child Health
Conference. The assessment is in the form of a questionnaire that is completed by the
parent of each child. If the assessment shows that a child is at risk, a capillary blood
test becomes necessary. This test is performed by the child's pediatrician or in
circumstances where the child has no pediatrician, by the Health Department. The test
consists of a fingerstick, which is done while the child is at Child Health Conference
with the physician and public health nurse in attendance. If the capillary test is
positive, the Health Department strongly advises the parents of the affected child to seek
confirmatory testing and necessary treatment. Although the primary responsibility of the
Health Department is in education and environmental remediation, the nursing staff must
monitor the medical progress of affected children and ensure that they receive essential
treatment.
J. Community Outreach and Ancillary Services
Public Health Nurses work as agents of the State in providing mandated services, in
providing information and education regarding State requirements and in monitoring,
auditing and enforcing compliance to State Codes. In this role, the public health nurses
receive inquiries from lay people regarding services and immunizations. They also receive
questions about health practices and resources in the community that are established to
provide public and private services to accommodate a variety of needs and problems related
to promoting health and preventing illness.
Businesses and professionals in the community also request information regarding the
interpretation of State requirements and operations as they apply to their line of work,
e.g., schools, day care centers, and senior citizens groups. Knowledge of the Community,
updates on State requirements, attendance at topical conferences and seminars, a library
of current books, newsletters and references, and individual research assist the nurses in
providing current and accurate responses to the inquiries. Education is a key
responsibility in assisting others to care for themselves or to provide services to others
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IV.
Health Education Services
A. Mammography Coupon Distribution
The Health Educator conducts a district wide program providing lowered cost mammography
screening to women at participating mammography centers. The Health Educator must enter
into contracts with the various mammography centers, produce the mammography coupons,
distribute these coupons to contracting communities, tabulate monthly data regarding the
distribution of the coupons, publicize the coupon distribution, and provide a report on
the program's progress.
B. The Madison Alliance Against Substance Abuse (MAASA)
The Madison Alliance Against Substance Abuse is the local unit of the Governor's
Council on Alcoholism and Drug Abuse charged to assess needs and develop programs for
primary prevention of drug and alcohol problems. MAASA is the designated body for
receiving Alliance program money from State Drug Enforcement Demand Reduction funds.
The Health Educator is the staff support for MAASA and represents the Mayor on the
Alliance. Responsibilities include coordinating the annual grant request and managing the
Alliance award for Madison; working closely with the Alliance chair on program direction,
county and state initiatives, and municipal programs; ordering materials with grant funds
and overseeing the MAASA Trust Account; and networking with community and county groups on
program ideas and
H. News Releases
The Health Educator researches, writes, and sends informative and educational
announcements of programs, services or concerns to newspapers, newsletters, radio stations
and TV stations. The Health Educator also produces posters announcing various Health
Department activities.
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V.
Registrar Services
A. Marriage Licenses
The Health Department's Administrative Officer and Assistant Administrative Officer
also serve as Registrar and Deputy Registrar. In this capacity they issue marriage
licenses to couples if either is a resident of Madison or to out of state
applicants who are getting married in Madison. Before the Registrar can issue a marriage
license, he/she must: verify Madison residency, review birth
certificates and driver's licenses or passports and divorce or death
certificates. The applicants and witness must recite an oath that all
information given is correct. The Registrar must collect a fee,
type the license, and issue it after seventy-two hours. Marriage
Licenses are filed in the town where the marriage was performed. After the applicants have been
married, the applications must be completed and filed, and the Registrar must send
licenses of couples married in Madison to the State Health Department.
The Registrar is also responsible for filing and forwarding to the State Health
Department marriage licenses of couples, who were married in Madison but had applied in
other municipalities.
B. Birth Transcripts
The Health Department's Registrar or Deputy Registrar issues birth transcripts to
anyone seeking information on people who were born in Madison. The files,
which date back to the 19th Century, have to be researched and the desired transcript must
be completed. To complete this service, transcript books and certificates of live births
must be ordered.
The Registrar is also responsible for receiving and filing (for one year) copies of
current birth certificates of children, born elsewhere, whose parents live in Madison.
Since these children were not born in Madison, copies of their Birth Certificates cannot
be issued to the general public.
C. Death Transcripts
The Health Department's Registrar and Deputy Registrar are responsible for issuing
death transcripts for anyone who has died in Madison. This service
includes receiving the death certificate from the Funeral Director, reviewing the death
certificate for accuracy and completeness, issuing the burial permit and death transcripts
to the Funeral Director, The death certificate is then filed or sent to the
town where the death occurred. The original death certificates are
sent to the State Registrar on a monthly basis. A list of people
who have died in Madison must be sent to the County Election Board on a monthly basis.
The Registrar is also responsible for receiving and filing (for one year) death
transcripts of Madison residents who died in another Municipality.
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VI.
Secretarial Services
The Health Department's Administrative Officer and Assistant Administrative Officer
satisfy the secretarial needs of the Health Department, Board of Health, and Welfare
Director.
The Administrative Officer and Assistant Administrative Officer support the Health
Officer by:
1. Preparing reports, correspondence, memorandums, statistical and financial
statements.
2. Assisting the Public in person and over the phone.
3. Preparing requisitions for the purchase of necessary services and supplies.
4. Maintaining control of accounting procedures.
5. Referring phone messages.
The Assistant Administrative Officer supports the Sanitary Inspector by:
1. Referring nuisance complaints.
2. Issuing various permits and licenses.
3. Typing reports.
4. Preparing and mailing violation notices.
5. Referring phone messages.
The Administrative Officer and Assistant Administrative Officer support the Health
Educator by:
1. Assisting with news releases and correspondence to other communities.
2. Typing reports.
3. Helping with the distribution of mammography coupons.
4. Assisting with correspondence, forms, grant work, and agendas related to Madison
committees such as MAASA.
5. Referring phone messages.
The Assistant Administrative Officer supports the nursing staff by:
1. Taking appointments for various health clinics.
2. Setting up patient charts for various health clinics.
3. Monitoring Child Health Clinic while in progress.
4. Typing reports.
5. Referring phone messages.
The Administrative Officer assists the Board of Health by:
1. Attending and taking minutes of Board of Health meetings.
2. Transcribing minutes of the Board of Health Meeting.
3. Preparing and distributing Meeting agenda, monthly reports, resolutions and
correspondence to individual Board of Health members.
4. Preparing and distributing correspondence from the Board of Health.
5. Preparing and distributing the Bills Payable report.
The Assistant Administrative Officer supports the Welfare Director by:
1. Referring phone messages.
2. Typing reports.
3. Assisting with correspondence.
4. Personally forwarding assistance checks to clients in the absence of the Welfare
Director.
The Administrative Officer and Assistant Administrative Officer manage Madison's dog
and cat licensing program. The following steps are necessary to perform this service:
1. Request specific information from the applicant.
2. Issue individual licenses via a computer program.
3. Request and record a license fee from each applicant.
4. Deposit fees received for the issued licenses.
5. Manage the files so that a monthly receipts report can be generated and sent to the
State Health Department.
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