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#WeDontPuff

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1. What is the #WeDontPuff Advocacy Council?

A group of talented, diverse youth brought together to form a board to advise the Tobacco Prevention Program on youth related topics and issues. The council is a group of youth who are committed to being ambassadors for this organization. These ambassadors will engage their community, show leadership, and work together to accomplish the goals of the tobacco prevention program.

2. What activities will the Youth Advocacy Council be involved in?

For the upcoming semester, the youth council will organize one event his/her school or community for Red Ribbon Week: Oct. 23-31, 2018; Kick Butts Day on March 20th, 2019; participate in World No Tobacco Day Community Fair on May 31st; and attend the summer conference for TNSTRONG “Tennessee Stop Tobacco and Revolutionize Our New Generation” (TBA). They will appear in our countywide advertisements, which include commercials, Youtube videos, billboards, social media posts, as well as provide much of the content for our social media accounts.

3. Will serving on this council interfere with school work?

The council will not require any more time than other clubs at any given school. Students will meet one Saturday a month throughout the time he or serves on the council. These meeting will last generally 1-2 hours.

4. What will the students need to participate?

It is ideal that the students have a mobile phone as well as an Instagram account. This will enable them to communicate with each other outside the meetings and make posts on the social media pages for #WeDontPuff events and activities.

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Air Pollution Control Permits

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1. Who needs a construction permit?

Any person wishing to construct an air contaminant source or to modify an existing air contaminant source, is required to obtain a construction permit from the Pollution Control Section of the Shelby County Health Department. Examples of air contaminant sources include:

- Fuel-burning equipment such as boilers, gas- or oil-fired heaters, and coal-fired steam plants generating electricity
- Incinerators for medical and municipal waste
- Process emission sources such as printing presses, asphalt plants, and coating processes

Farming equipment, mobile sources, and other exempted air contaminant sources are not required to obtain a construction permit.

2. What is an air contaminant source?

For construction permitting purposes, air contaminant sources typically are classified as major or minor sources depending on their potential to emit pollutants. Major sources generally are:

- Sources that are subject to New Source Performance Standards (NSPS) and have potential total facility emissions greater than 100 tons per year (tpy)
- Sources with potential total facility emissions greater than 250 tpy or more of the following criteria pollutants: carbon monoxide, particulate matter, nitrogen dioxide, sulfur dioxide, lead, and ozone

Minor sources are sources of air contaminants that are not major sources and are not exempt from construction permit requirements. Examples include concrete batch plants, medical waste incinerators, and small surface coating and printing operations.

3. Who needs a Title V Operating Permit?

The answer to this question can be found on this page.

4. What information for Title V Permits must I provide?

All applicants must submit a Major Source Operating Permit Application. The following information is needed to complete the application:

- Certification of compliance with all applicable requirements
- List of compliance methods for demonstration of compliance with applicable requirements
- Description of processes and products
- Emissions of regulated air pollutants
- Facility identification information
- Fuels, fuel use, raw materials, production rates, and operating schedules
- Information on air pollution control systems

All existing Title V sources were required to submit Title V applications on or before August 28, 1997. Any source that becomes subject to this requirement must submit an application within the time specified on its construction permit.

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Child Car Seat Program

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1. How can I make an appointment for a convertible child car seat ?

Call the Shelby County Health Department at 901-222-9276.

2. How can I locate a program that offers booster seats for children?

Call the Police Department located in your specific neighborhood.

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Childhood Lead Poisoning Prevention Program

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1. What is Lead?

Lead is a naturally occurring element found in small amounts in the earth's crust. While it has some beneficial uses, it can be toxic to humans and animals, causing health effects. 

2. What is Lead Poisoning?

Lead poisoning is a disease that can cause serious health problems, such as brain and kidney damage, coma, and even death. You should be concerned if your child tests at even a low level; any lead level in the blood is a concern. Even small blood lead levels can lead to learning problems and hyperactivity.

3. What are Sources of Lead Poisoning?

Lead can be found in many products and locations. Some you might never have thought of, including some imported candies, toys, and traditional medicines. The most common cause of lead poisoning is in homes built before 1978 (when lead-based paints were banned), probably containing lead-based paint. When the paint peels and cracks, it makes lead dust. Children can be poisoned when they swallow or breathe in lead dust. However, some non-paint sources, though less common, can cause severe cases of lead poisoning and can be dangerous if not managed properly.

Lead can be found throughout a child's environment.

• Certain water pipes may contain lead.
• Lead can be found in some products, such as toys and jewelry.
• Lead is sometimes in candies imported from other countries or traditional home remedies.
• Specific jobs and hobbies involve working with lead-based products, like stain glasswork, and may cause parents to bring lead into the home.
• Children who live near airports may be exposed to lead in air and soil from aviation gas.

4. What are the Signs and Symptoms of Lead Poisoning?

Many children with lead poisoning have no symptoms. But even low-level lead exposure can lead to learning and behavior problems, like trouble paying attention. Symptoms of lead poisoning include:

• loss of appetite
• feeling tired or irritable
• poor growth
• nausea and vomiting
• constipation
• stomach pain
• joint pain and muscle weakness
• headaches

Note, very high lead levels can cause confusion, seizures, coma, and even death. 

5. Who is at Risk?

Lead is toxic to everyone, but children younger than six years are at the most significant risk because their growing bodies absorb more information than adults do. Children's brains and nervous systems are more sensitive to the damaging effects of lead. Babies and young children can also be more highly exposed to lead because they often put their hands and other objects with lead from dust or soil on them into their mouths. Children may also be exposed to lead by eating and drinking food or water containing lead or from dishes or glasses that have lead, inhaling lead dust from lead-based paint or lead-contaminated soil, or from playing with toys with lead-based paint.

Adults may be exposed to lead by eating and drinking food or water containing lead or from dishes or glasses that have lead. They may also breathe lead dust by spending time in areas where lead-based paint is deteriorating. During renovation or repair work, it disturbs painted surfaces in older homes and buildings. Working in a job or engaging in hobbies where lead is used, such as making stained glass, can increase exposure, as can specific folk remedies containing lead. A pregnant woman's exposure to lead from these sources is of particular concern because it can result in exposure to her developing baby.

6. What are the Health Effects of Lead?

Lead can affect almost every organ and system in your body. Children six years old and younger are most susceptible to the effects of lead.

Children

Even low levels of lead in the blood of children can result in:

1. Behavior and learning problems
2. Lower IQ and Hyperactivity
3. Slowed growth
4. Hearing Problems
5. Anemia

In rare cases, ingestion of lead can cause seizures, coma, and even death.

Pregnant Women

Lead can accumulate in our bodies over time, where it is stored in bones and calcium. During pregnancy, lead is released from the mother's bones and calcium and can pass from the mother exposing the fetus or the breastfeeding infant to lead. This can result in severe effects to the developing fetus and infant, including:

1. Cause the baby to be born too early or too small;
2. Hurt the baby's brain, kidney's, and nervous system;
3. Increase the likelihood of learning or behavioral problems; and
4. Put the mother at risk for miscarriage.

Check out the websites below for more about lead's effects on pregnancy and lactating women:

Effects of Workplace Hazards on Female Reproductive Health, National Institute for Occupational Safety and Health. 

Guidelines for the Identification and Management of Lead Exposure in Pregnant and lactating Women, National Center for Environmental Health. https://www.cdc.gov/nceh/lead/publications/leadandpregnancy2010.pdf 

Other Adults

Lead is also harmful to other adults. Adults exposed to lead can suffer from:

1. Cardiovascular effects increased blood pressure and incidence of hypertension;
2. Decreased kidney function; and
3. Reproductive problems (in both men and women). 

7. How Do I Get my Child Tested for Lead Poisoning?

If you are concerned that your child might be at risk for lead poisoning, talk with your doctor, your child's pediatrician, or contact the Shelby County Health Department Childhood Lead Poisoning Prevention Program (CLPPP) at 901-222-9582 or by email at schd.clppp@shelbycountytn.gov for information on screening and testing for lead poisoning.

(NOTE: Here is a video demonstrating the testing procedure: https://youtu.be/O0JSKqzfc9k.)

8. How Much Does It Cost to Get my Child Tested for Lead Poisoning?

Free lead testing is available at all Shelby County Health Department clinics between 9:00 a.m. to 3:00 p.m. 

The list of Shelby County public health clinics and their addresses is below:

Cawthon Public Health Clinic

1000 Haynes, 38114

 

Collierville Public Health Clinic

(Tues. & Thurs. only)

167 Washington St., 38017

 

Hickory Hill Public Health Clinic

6590 Kirby Center Cove, 38118

 

Immunization Clinic

814 Jefferson, Rm. 216, 38105

 

Millington Public Health Clinic

8225 Highway 51 North, 38053

 

Shelby Crossing Public Health Clinic

6170 Macon Road, 38133

 

Southland Mall Public Health Clinic

1287 Southland Mall, 38116

 

No appointment or proof of health insurance is required, but a parent or legal guardian must accompany the child.

9. How Do I Get my Home or Building Tested?

For determining whether lead-based paint is present in pre-1978 homes and buildings, or for assistance with lead poisoning prevention, including information on grants to remove lead-based paint hazards from lead in paint, dust, or soil, please get in contact with the Shelby County Department of Housing at 901-222-7600 and City of Memphis Housing and Community Development at 901-636-LEAD (5323) for information on conducting a risk assessment to determine if there are lead hazards. CALL TODAY TO SEE IF YOU QUALIFY FOR A LEAD-BASED PAINT HOME INSPECTION AT NO COST TO YOU (click attachment Lead-Safe Program Flyer.pdf!!)

10. What are Some Tips for Lead Poisoning Prevention?

Prevention

Lead poisoning is preventable. The goal is to prevent lead exposure to children before they are harmed. There are many ways parents can reduce a child's exposure to lead. The key is stopping children from coming into contact with lead. Lead hazards in a child's environment must be identified, controlled, or removed safely.

1. Women planning on having children, pregnant women, and children should not be present in housing built before 1978 undergoing renovation. They should not participate in activities that disturb old paint or clean up paint debris after work is completed.
2. EPA has a Lead Renovation, Repair and Painting (RRP) Rule that establishes requirements for firms and individuals performing renovations, and affects contractors, property managers, and others who disturb painted surfaces. A contractor renovating/remodeling a house built before 1978 needs to be trained and licensed to work with lead. Contractors must also provide homeowners with a copy of EPA's Renovate Right before work begins. 
3. Create barriers between living/play areas and lead sources. Ensure your child does not have access to peeling paint or chewable surfaces painted with lead-based paint. Until lead remediation is completed, parents should clean and isolate all lead sources. They should close and lock doors to keep children away from chipping or peeling paint on walls or apply temporary barriers such as furniture or plastic to block children's access to sources of lead.
4. Regularly wash children's hands and toys. Hands and toys can become contaminated from household dust or exterior soil. Both dust and soil can be sources of lead.
5. Regularly wet-mop floors and wet-wipe window components. Because household dust is a major source of lead in older houses, parents should wet-mop floors and wet-wipe horizontal surfaces every two to three weeks. Windowsills and troughs may contain high levels of lead dust and should be kept clean. If feasible, windows should be closed to prevent abrasion of painted surfaces or opened from the top sash.
6. Prevent children from playing in bare soil. Parents should plant grass on bare soil or cover the soil with grass seed, mulch, or gravel. Parents should move play areas away from bare soil until the bare soil is covered. 
7. Pets can also bring lead into the home. Dogs and cats with access to the outdoors could play in lead-contaminated soil and track that soil into the house and children.
8. Occupations with possible lead exposures may have set procedures per the Occupational Safety and Health Administration (OSHA) standards to prevent exposure of taking lead home. If not, you can take steps to Protect Yourself at Work. Lead safety practices include showering before leaving work, changing clothes/shoes, and leaving work attire/equipment at work. All clothing with possible lead exposure is recommended to be washed separately and cleaned with an additional rinse cycle to clean out any lead dust that may be left behind. It is also advisable to vacuum your car using a high-efficiency particulate air (HEPA) filter.
9. If drinking water is of concern for lead contamination because of pipes or faucets in your home, flush the lines by running water for 15 to 30 seconds before using cold water only for drinking or cooking. Call your local health department or download the Important Information About Lead in Your Drinking Water brochure to identify possible sources of lead in water.
10. Importance of a Healthy Diet-Children with empty stomachs absorb more lead than children with full stomachs. Provide your child with four to six small nutritious meals during the day. The following nutrients can help protect your child from absorbing lead:
11. Iron-Rich Foods protect the body from the harmful effects of lead. Good sources of dietary iron include: lean red meats, fish, and chicken; iron-fortified cereals, and dried fruits (raisins, prunes)
12. Calcium-Rich Foods reduce lead absorption and help make teeth and bones strong. Good sources of dietary calcium include: milk, yogurt, cheese, and green leafy vegetables (spinach, kale, collard greens)
13. Vitamin C-Rich Foods work together to reduce lead absorption. Good sources of vitamin C include: oranges, orange juice, grapefruits, grapefruit juice, tomatoes, tomato juice, and green peppers

For healthy eating tips, please click the link from U.S. Environmental Protection Agency (EPA) Fight Lead Poisoning with a Healthy Diet: Lead Poisoning Prevention Tips for Families https://www.epa.gov/sites/default/files/2020-01/documents/fight_lead_poisoning_with_a_healthy_diet_2019.pdf

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Chronic Disease Management

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1. What is diabetes?

Diabetes is a disease in which blood glucose (sugar) levels are above normal (normal range is from 70-130). When you have diabetes, your body either doesn't make enough insulin or can't use its own insulin as well as it should. This causes sugar to build up in your blood.

2. What are the signs and symptoms of diabetes?

• Excessive thirst (extremely thirsty, more than usual)
• Extreme hunger
• Feeling very tired much of the time
• Frequent urination (going to the bathroom a lot)
• More infections than usual
• Sores that are slow to heal
• Sudden vision changes (changes in your eyesight)
• Tingling or numbness in hands or feet
• Unexplained weight loss (losing weight and you’re not trying to)
• Very dry skin

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Clinical Services

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1. What does Women, Infants, and Children (WIC) program provide?

WIC provides the following:
- A food voucher to be redeemed at the grocery store.

- Breastfeeding support.

- Linkage to other health care, i.e.: well child exams, immunizations, and lead screening.

- Nutrition education.

2. What do I need to bring when I sign up for WIC services?

The following information will be needed when applying for WIC:
- Crib card from the hospital or birth certificate (sixty days old or less).

- Proof of identity and proof of person receiving the vouchers.

- Proof of income.

- Proof residency.

- Shot record for infants and children.

3. Is a medical exam required for WIC services?

WIC accepts physician referral information if not older than 60 days. A WIC exam can be done at the clinic.

A WIC exam is:
- Due Date for Pregnant Women

- Height and Weight

- Hematocrit or hemoglobin (if over nine months of age)

WIC participants must be present at each certification.

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Community Health Assessment

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1. What was the outcome of the most recent MAPP process?

Five strategic health priorities were identified:

1) Mental Health
2) Healthy Lifestyles
3) Violence
4) Health Disparities/Social Determinants of Health
5) Increased Collaboration, Communication and Coordination in the Public Health System

2. How can I get involved in the MAPP process?

Five Communities of Practice have been established. If you are interested in one of the strategic health priorities, contact Amy Collier or Angela Moore.

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Environmental Health & Food Safety

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1. How much does it cost for a food service permit?

For 50 seats or less it is $210 per year.

For 51 seats or more is $360 per year.

Bar fee is $100.

2. Where can I see restaurant scores?

For restaurant scores please visit the Tennessee Department of Health. 

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Ethylene Oxide (EtO)

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1. Does this cause respiratory problems and shortness of breath, along with fatigue?

Based on available data, EPA does not expect EtO levels in the outdoor air around facilities like Sterilization Services of Tennessee to be high enough to cause immediate health effects (these are known as "acute” effects).  Short-term inhalation exposure to high amounts of EtO can cause headache, dizziness, nausea, fatigue, respiratory irritation (such as coughing, shortness of breath, wheezing) and, in some cases, vomiting and other types of gastrointestinal distress. Those effects do not usually occur with exposure to “fugitive emissions,” the amounts that typically escape facilities like Sterilization Services of Tennessee. 

2. Is it possible that there were residents who had moved away from the area who might have cancer, but were not included in the study?

Yes, it is possible. Tennessee Cancer Registry data is linked to the address where a cancer patient resided at the time of diagnosis. If the patient moved away from the risk area before diagnosis, they would not be geographically linked to the area surrounding Sterilization Services of Tennessee.

3. Are people with lead exposure more vulnerable? Many homes have lead water lines. Over 90% of children tested for lead in this area.

There is no evidence that exposure to lead or other chemicals makes individuals more vulnerable to ethylene oxide. EtO is carcinogenic to humans by inhalation (when breathed in air). EtO is not believed to be absorbed readily by water and soil. However, lead does linger in water and soil. Children whose brains and nervous systems are still developing are most vulnerable to lead exposure. Shelby County Health Department’s Childhood Lead Poisoning Prevention Program provides services to the community to increase awareness of the hazards of lead exposure, reduce lead exposure, and increase the number of children screened and tested for lead poisoning. If you have concerns about lead exposure in your home or environment, contact the Childhood Lead Poisoning Prevention Program at 901-222-9582. 

4. Is there a reason that throat cancer, aneurysms and other cancers are not included in this study?

Scientific evidence in humans indicates that regular exposure to EtO over many years increases the risk of cancers of the white blood cells, including non-Hodgkin lymphoma, myeloma, and lymphocytic leukemia. Studies also show that long-term exposure to EtO increases the risk of breast cancer in women. There is not strong evidence to link EtO exposure to other types of cancer.

5. The former Trump Administration rolled back many EPA regulations. Can we ever be safe again?

The Biden Administration recently signed an executive order to further embed environmental justice into the work of all federal environmental agencies, bring clean energy and healthy environments to all, and recognize, undo, and mitigate harm to those who have suffered from toxic pollution and other environmental burdens like climate change. The Biden Administration has also established a White House Environmental Justice Advisory Council to ensure that environmental injustices and inequities in communities like South Memphis are addressed. 

 

6. When did these gas emission results cause the EPA to become involved at this late date? The owners should have done their extensive study prior to establishing this hazardous source in our community.

When the Sterilization Services of Tennessee facility began using EtO decades ago, the health risks posed by EtO exposure were not well understood. As more studies were done and data became available, EPA began the process of updating regulations regarding EtO. This process began in 2022 and the proposed revised regulations were released by EPA on April 11, 2023. 

7. Will the Health Department do any testing on individuals for potential cancer of any kind?

SCHD refers residents to cancer screening programs such as the Tennessee Breast and Cervical Screening Program and federally qualified health centers that provide care on a sliding fee scale. 

8. Has Sterilization Services said they would lower their Ethylene Oxide emissions?

No, the company has not committed to taking any action before the revised EPA standards go into effect in 18 months.

9. Why hasn’t our Health Department used their authority to force Sterilization Services to reduce Ethylene Oide emissions? Our Health Department has the authority by law to do this.

Sterilization Services of Tennessee complies with all current federal, state, and local regulations. The Clean Air Act does not currently allow Sterilization Services of Tennessee to be held to legal standards higher than existing ones. The EPA is now in the process of updating Clean Air Act regulations to reduce allowable EtO emissions to better protect communities like South Memphis. As required by law, SCHD will ensure that the revised federal regulations regarding EtO are enforced as quickly as possible in Shelby County. 

10. What actions are being taken against the Sterilization company? These types of companies should be in remote areas.

As required by law, SCHD will ensure that the revised federal regulations regarding EtO are enforced as quickly as possible in Shelby County. 

11. Why are these meetings held so far away from the communities affected? This church is 3.3 miles away from the facility. What about folks without transportation?

Shelby County Health Department was unable to find a location within the risk area that provided the necessary space and the audio/visual capabilities required to hold a hybrid live/virtual meeting. 

12. Is there a lawsuit in the making for this matter because I hurt every day?

Shelby County Health Department has no information about any pending lawsuits regarding EtO.

13. When should the resident of 38109 expect any of these pending cancer-causing studies to be completed? What other actions in our regard should be taken?

The cancer cluster study requested by Shelby County Health Department has been completed. SCHD has also requested a Public Health Assessment (PHA) and a Health Consultation (HC) from the federal Agency for Toxic Substances and Disease Registry (ATSDR) to identify health risks related the usage of Ethylene Oxide (EtO) and other chemicals in the area surrounding the Sterilization Services facility. Those studies have not yet begun. 

14. What should you do if you have been diagnosed with cancer?

Those diagnosed with cancer should comply with all their physician’s recommended treatment guidelines. 

15. What should you do if you have cancer and do not have insurance for treatment?

A federally funded program called the Tennessee Breast and Cervical Screening Program provides screenings, diagnostic and other procedures for under-insured and uninsured Tennessee residents specifically for breast and cervical cancers. Federally qualified health centers provide recommended screenings and treatment options for other cancers. 

16. What can the Health Department do to provide access to care to those in the affected area?

The Health Department does not provide primary health care, however, we strongly encourage that everyone have a primary care provider who manages their health care. A primary care provider can recommend appropriate cancer screenings for persons exposed to EtO. Un- and under-insured persons can receive affordable health care at Federally Qualified Health Centers (FQHCs). To find an FQHC near you, go to https://findahealthcenter.hrsa.gov/ and enter your address. There are 23 FQHCs in and near Memphis, TN. 

17. How long does it take for EPA’s proposed rule to become final and how long will facility have to comply? Will Sterilization Services consider making voluntary changes after the rule is published?

Under the proposal, facilities would be required to comply with these new requirements within 18 months. This represents an expedited timeline under EPA authority. The Sterilization Services of Tennessee management has not indicated it will make any voluntary changes in emissions before the new requirements go into effect 18 months from now. 
 

18. Why does the Health Department not shut the facility down as a

Sterilization Services of Tennessee complies with all current federal, state, and local regulations. The Clean Air Act does not currently allow Sterilization Services of Tennessee to be held to legal standards higher than existing ones. The EPA is now in the process of updating Clean Air Act regulations to reduce allowable EtO emissions to better protect communities like South Memphis. As required by law, SCHD will ensure that the revised federal regulations regarding EtO are enforced as quickly as possible in Shelby County. 

19. What are the individual services at the Shelby County Health Department?

Shelby County Health Department offers cancer screening programs  for uninsured and underinsured individuals.

We work in conjunction with hospital systems, health care providers, and community organizations to make health screenings and preventive care available throughout the community.

 

20. What are ways that the Shelby County Health Department can be more trustworthy to the community?

The Shelby County Health Department is a division of Shelby County Government. We work for the people and answer to the representatives of the people, the elected Mayor and Commissioners of Shelby County. We strive to be responsive and accountable to the community at all times. 

21. When did EPA last review this and change emission standards?

The standard for EtO has not been changed since it was established in the 1970s.

22. What makes people more vulnerable to cancer from EtO?

EtO is a human carcinogen. It causes cancer in humans. Scientific evidence in humans indicates that regular exposure to EtO over many years increases the risk of cancers of the white blood cells, including non-Hodgkin lymphoma, myeloma, and lymphocytic leukemia. Studies also show that long-term exposure to EtO increases the risk of breast cancer in women.

Workers who use EtO as a part of their jobs and people who work, live, or go to school or daycare near facilities that use EtO may breathe in EtO at levels that can increase cancer risk. This risk is not the same for everyone and depends on how long a person is exposed over the course of their lifetime or career, as well as how much EtO is actually in the air. The distance from a facility or other EtO source plays a big role in how much EtO might be in the air.

Because children’s bodies are growing, they are expected to be more susceptible to the toxic effects caused by EtO. This is because EtO is mutagenic, meaning it can damage DNA. As children grow, they tend to be more susceptible to the harmful effects caused by chemicals, including chemicals that are mutagenic. For anyone, including children, risks would decrease with decreased exposure.

23. Does the lack of evidence of cancer clusters mean there is no elevated risk of cancer?

No.  Cluster studies are done to combine the science of what is known about cancer with geographic analysis – proximity to the facility within constraints.

24. Instead of conducting a cancer incidence study, why not test Ethylene Oxide levels in the air?

Shelby County Health Department cannot place an air monitoring station on our own without the permission of the EPA.

Ethylene oxide is hard to measure; very heavy gas emitted; immediately falls to the ground and is difficult to test for.

25. What has Sterilization Services said they would do?

The Sterilization Services has not issued any statements about their plans for the Memphis facility.

26. Would it not be better to move the sterilization plant to another area as a preventative measure for the safety of the neighborhood?

The Shelby County Health Department's authority is limited, but specific. SCHD cannot ask this industry to move somewhere else. The industry is not only regulated by the Shelby County Health Department, but also Codes Enforcement, Zoning, etc. The facility meets the current EPA standard, meaning that the operation meets the local, state, and federal compliance regulations. Local, state, and federal authorities cannot hold the facility to a higher standard than the current law allows.

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FIMR

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1. How do I receive a Pack N Play?

Email FIMRinfo@shelbycountytn.gov to complete a 15 minute Safe Sleep application. 

2. I recently had twins. Do I receive a crib for both babies?

Yes. You may have two cribs to support your twins. 

3. Do you all provide car-seats?

No. Car seat distribution is handled by Presumptive Eligibility. Their contact information is 222 - 9276. Please allow them 24 - 48 hours to return your phone call.  

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Health & Wellness Section

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1. How can I get someone to do a presentation from your section?

Contact Margaret Gates.

2. How can we get more information on the topic of Healthy and Active Living?

Contact Margaret Gates.

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Health Promotion

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1. Why is obesity a growing problem?

Obesity has become a problem due to changes in the way we live, work, and play. We devote less time to being physically active. We drive more and walk less. We spend more hours sitting in front of screens - watching television, playing video games, browsing the internet, or engaging with our mobile devices. Our habits around food have changed, too, as we eat bigger and bigger portions of less healthful foods.

2. How do I get health education materials for my group?

Contact Rosalind Stevenson.

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HIV & STDs

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1. Will the testing and counseling be confidential?

Yes. We are governed by HIPPA laws. It’s a HIPPA violation to give partner information. Learn more about Health Information Privacy.

2. What is the waiting period for test results?

The wait time for results is typically 5 working days.

3. How long from HIV exposure should I get tested?

You should be tested within two (2) weeks of exposure to HIV.

4. How often should I be tested after exposure to HIV?

You should be tested every three (3) months for one (1) year.

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Maternal & Child Health (MCH)

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1. How does a family receive information for an infant safe sleep environment?

The baby must reside in Shelby County and be 5 months or younger. Infant Safe Sleep Resources are available at no cost. For additional information, please contact 901-222-9132.

2. Where can I get breastfeeding support?

Breastfeeding support classes are offered at the SCHD Clinic Locations (include schedule) and information is available on the Tennessee Breastfeeding Hot line.

The Tennessee Breastfeeding Hot line, staffed by International Board Certified Lactation Consultants and Certified Lactation Counselors, is available to nursing mothers and partners, their families, expectant mothers, and health care providers seeking breastfeeding support and information. For more information please visit the Tennessee Breastfeeding Hot line website.

3. What is the HUGS program?

HUGS is a home-based care coordination program developed by the Tennessee Department of Health. The home visiting staff follows prenatal/postpartum women, children through 5 years of age and the parent/guardian of the client referred to the program.

For those that have experienced the loss of a child less than 2 years old (due to SIDS, prematurity, Etc.) grief counseling is provided. Families must live in Memphis and Shelby County.

4. Is there a fee for HUGS services?

The program is free.

5. Who provides the HUGS services?

A health care professional is assigned to each family.

6. Where is lead most commonly found?

House Paint is the main source of lead that affects young children. Lead can seep into the water if your home has lead pipes or copper pipes with lead solder. Lead can be in your soil or in lead contaminated dust, especially in old houses and buildings. For additional information please call 901-222-9492.

7. My child was born with special health care needs. Where can I find assistance and information?

The Children’s Special Services (CSS) program assures appropriate, timely, comprehensive, quality services to children from birth to 21 who have or are at-risk for special needs.

The program promotes the well-being of children in a manner that is family-centered, culturally sensitive and community based through service coordinators acting as liaisons for children, families and providers by facilitating, collaborating and forming partnerships that are flexible and creative in meeting the unique needs of each child.

For additional information please call 901-222-9960.

8. Why do I need to have my child tested for Newborn Screening?

All babies born in the State of Tennessee are tested for metabolic and genetic disorder- this procedure is mandated by law. Please contact 901-222-9510 for additional information.

9. What is FIMR?

The Fetal and Infant Mortality Review (FIMR) Program provides support to parents and families whose lives have been affected by the tragic death of a child or loss of a pregnancy. For additional information, please contact 901-222-9132.

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Monitoring Wells & Soil Boring Permits

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1. What type of remediation activity requires that an application be submitted for a permit?

Any type of monitoring well, recovery well, deep soil boring, geoprobe or any activity associated with remediation at a site within Shelby County requires that an application be submitted to the Water Quality Branch and Septic Tank Program for the proposed work at the location.

2. Are permits required to abandon monitoring wells?

Any abandonment process of monitoring wells, recovery wells, soil borings, geoprobe or similar activities require that an abandonment permit be issued for the work at the site.

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Monkeypox FAQs

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1. What is mpox (monkeypox)?

Mpox (monkeypox) is a rare disease caused by infection with the mpox virus. The virus is part of the same family of viruses as the variola virus, which causes smallpox. Mpox symptoms are similar to smallpox symptoms but milder, and mpox is rarely fatal. It is not related to chickenpox. 

2. Is mpox deadly?

Infections with the mpox virus identified in this outbreak are rarely fatal. Over 99% of people who get this form of the disease are likely to survive. However, people with weakened immune systems, children under eight years of age, people with a history of eczema, and people who are pregnant or breastfeeding may be more likely to get seriously ill or die. Contact your primary care physician or provider if you are experiencing symptoms or have a rash.

3. Who is at risk for mpox?

Anyone in close contact with a person with mpox is at risk and should take steps to protect themselves. People who do not have mpox symptoms cannot spread the virus to others.

Current cases are primarily spreading through sex and other intimate contact among social networks of gay, bisexual and other men who have sex with men (MSM); transgender people; gender-nonconforming people; and nonbinary people. People in these social circles who have multiple or anonymous sex partners are also at a high risk of exposure.

Mpox is not considered a sexually transmitted disease, but it is often transmitted through close, sustained physical contact, which can include sexual contact. Anyone, regardless of their sexual orientation can get and spread mpox.

4. What are the symptoms of mpox?

Symptoms of mpox can include: fever, headache, muscle aches and backache, swollen lymph nodes, chills, exhaustion, respiratory symptoms (e.g. sore throat, nasal congestion, or cough) and a pimple-like rash that may be located on or near the genitals or anus but could also be on other areas like the hands, feet, chest, face, or mouth. The rash will go through several stages, including scabs, before healing. Sometimes, people get a rash first, followed by other symptoms. Others only experience a rash.

Mpox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

 

5. How is mpox spread?

Mpox spreads in different ways. The virus can spread from person-to-person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex. In addition, pregnant people can spread the virus to their fetus through the placenta.

Mpox is transmitted to humans through close contact with an infected person or animal, or with close contact with materials contaminated by the virus.

Touching items that previously touched the infectious rash or body fluids, including clothing, towels, or bedding is another way mpox spreads.  It’s also possible for people to get mpox from infected animals, either by being scratched or bitten by the animal or by eating meat or using products from an infected animal.

6. Should I get vaccinated?

Tennessee Department of Health (TDH) is directing the distribution of all JYNNEOS monkeypox vaccine in Tennessee. The vaccine is distributed to regional and county health departments only on an as-needed basis and currently can only be given to the following:

1. Individuals with a known contact/exposure to monkeypox identified through public health interviews during the prior 14 days

2. Individuals who might have been exposed to mpox in the past 14 days, including if they:

• Are aware that a sexual partner was diagnosed with mpox in the past 14 days
• Have had multiple sexual partners in the past 14 days

3. Gay, bisexual, or other men who have sex with men (MSM), and/or transgender, gender-nonconforming or gender non-binary individuals who report any of the following in the last 90 days:

• Having multiple sex partners or anonymous sex
• Being diagnosed with a sexually-transmitted infection (STI)
• Receiving medications to prevent HIV infection (HIV PrEP)
   
   

Tennessee Department of Health vaccine information

7. Where can I get vaccinated?

Shelby County Health Department has received a limited supply of Jynneos vaccine to those who meet the criteria listed above. It is offered at the 814 Jefferson Avenue location.

8. What are the treatments for mpox?

There are no treatments specifically for mpox virus infections. However, because of genetic similarities in the viruses, antiviral drugs and vaccines used to protect against smallpox may be used to prevent and treat mpox infections. TPOXX is an antiviral drug that may be recommended for people who are more likely to get severely ill. JYNNEOS^TM  is a vaccine, which has been approved by the U.S. Food and Drug Administration for the prevention of mpox. Most people with mpox recover fully within 2 to 4 weeks without the need for medical treatment.  If you have symptoms of monkeypox, you should talk to your healthcare provider

Information about monkeypox treatment from the CDC

9. What if I have an adverse reaction to the vaccine?

If you have signs of a severe allergic reaction (such as hives, swelling of the face or throat, difficulty breathing, a fast heartbeat, or dizziness), call 911 immediately or go to the nearest hospital. For other concerns, contact a health care provider.

Adverse reactions should also be reported to the Vaccine Adverse Event Reporting System (VAERS). Your health care provider will usually file this report. Visit: https://vaers.hhs.gov/ or call 800-822-7967. VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.

Vaccine Adverse Event Reporting System

10. Where can I get tested?

If you think that you need to be tested for mpox, you should talk with your doctor, nurse or medical provider about your symptoms. All primary care physicians and other medical providers should be able to evaluate patients for suspected monkeypox and collect a specimen for testing if indicated. A direct swab of a suspected mpox lesion is the only reliable way to test for the disease. That means if you don’t have a rash/lesions, you cannot be tested.  

Talk to your health care provider if you think you have been exposed to mpox or are at high risk for exposure.

 

FDA information about monkeypox testing

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Needle Disposal Program

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1. What type of payment is accepted?

Currently we are accepting cash only.

 

2. What is include in the fee?

A one gallon sharps container and disposal service.

3. Can sharps containers be dropped of at any of the Shelby County Health Department’s satellite locations?

No, currently the only drop off location is at 814 Jefferson. 

4. Can I purchase more than one container at a time?

A maximum of two (2) containers per customer can be purchased per year.

5. Why is it important to properly dispose of syringes, needles, and lancets?

Disposing of your needles and sharps the wrong way can cause needle sticks and injury that may result in transmission of disease.

6. Why can’t needles, syringes or lancets be thrown in the trash?

The general public can be at direct risk to injuries from sharps. If these hazardous materials are not separated from standard waste, individuals can unknowingly come in contact with them. In addition, if sharps waste is not disposed, and removed from the environment, then it can be subject to reuse and misuse (both intentional and unintentional).

7. What are the hours of operations?

Monday-Friday, 8:00 a.m.-4:30 p. m.

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Open Air Burning & Land Clearing

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1. What information must I provide for an open air burning permit?

The following information must be provided when a controlled permit is issued:

- Address of company or individual
- After-hours contact number for emergency use
- Location of burn site
- Name of company or individual conducting the burn
- Telephone number of operator

2. What fees are required for an open air burning permit?

The permit fee for a temporary controlled burn pit is $130. An additional permit fee and inspection is required if the burn pit is relocated or if burning is necessary beyond the 30-day limit.

3. What are my rights and responsibilities after the permit is approved?

During the permit period, the fire department with jurisdiction in your area must be notified each day before burning begins and again when burning ends for the day. Also, someone must be at the site to monitor the pit when burning is taking place. The operator is responsible for compliance with all rules and regulations governing open burning permits and any damages, injuries, or claims resulting from such burn.

4. What are the section's rights and responsibilities after the permit is approved?

The Pollution Control Section is responsible for protecting Shelby County's air quality. Requiring a source (or a business) to obtain an open burning permit ensures compliance with the established rules, thereby, decreasing the impact on nearby residents and maintaining overall air quality.

The section has the right to conduct routine inspections as deemed necessary. The section may suspend or revoke any open burning permit if the permit holder fails to comply with the provisions, stipulations, or compliance schedules specified in the permit. The Memphis Shelby County Air Code provides for civil penalties of up to $25,000 per day for each day of violation.

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Public Health Emergency Preparedness Program - Cities Readiness Initiative

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1. Why is the Cities Readiness Initiative necessary?

The Cities Readiness Initiative is needed to enhance preparedness at all levels of government and to provide a consistent nationwide approach to prepare for, respond to, and recover from a large-scale public health emergency.

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Septic Tank Permits

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1. What is the minimum lot size where public sewer service is not available to install a sewage disposal system?

In Shelby County, the lot must be at least two (2) acres in size, excluding all road easements, utility easements, ponds or similar usage on the lot.

2. What is a complete application set consist of for a sewage disposal system?

1. An original color coded high intensity soil map must be submitted with the application packet.

2. The fee is $175.00 for a subsurface sewage disposal permit.

3. A plot plan must be submitted that will identify any underground utilities, natural gas lines, and the location of the house, water wells or similar structures on it.

4. Also, the plot plan must show the exact location of the septic tank and field lines.

5. Along with the information listed above, a soil analysis for the lot must be sent with the plot plan in order to verify that the soil is suitable for a subsurface sewage system at the site.

6. In addition to the exact location being plotted on a plot plan the exact location of the field lines and septic tank must also be drawn onto one of the soil maps that are submitted for approval by the department.

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Stage I Vapor Recovery Control

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1. How will my application be processed?

An APC-2-01 Permit Application General Information form must be completed and signed.

Notification of Compliance Status for Gasoline Dispensing Facilities-Stage I Vapor Recovery form must be completed and signed. This will assist in determining whether or not the gasoline facility is required to be permitted or not.

When all applicable requirements are satisfied and fees paid an operating permit will be issued.

2. What are my responsibilities after the permit is issued?

The operator is responsible for compliance with all rules and regulations governing the Stage I Vapor Recovery gasoline dispensing facility.

3. What fees are required for a Stage I Vapor Recovery Gasoline Dispensing Facilities (Gas Stations) Permit?

Annual Permit / Permit Application Fee - $65

Name Change - $130

Ownership / Name Change - $130 + Annual Permit Fee ($65) = $195

Modification Fee - $130

New Construction Fee - $265 + Annual Permit Fee ($65) = $330

The station owner or operator must apply for and receive an operating permit no later than Ninety (90) days after initial start-up. 

If your station is subject to permitting and the Compliance Status form along with the Application form has not been received, the Department may consider enforcement action for operating without a permit.

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Tennessee Breast and Cervical Cancer Program

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1. How can receive a free mammogram or pap test?

Call the Shelby County Health Department at 901-545-8720 or 901-545-8710. 

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Tobacco Prevention

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1. Are there resources for people who want to quit smoking?

For more information, visit our Tobacco Quit-Line Page.

2. How do I get tobacco education materials for my group?

Contact Marcha Bradley.

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Tuberculosis Comorbidities & Risk Factors

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1. Does HIV make a person more susceptible to TB?

HIV does make an individual more susceptible to tuberculosis. A weakened immune system increases the likelihood of converting to tuberculosis disease. The diagnosis also makes treatment somewhat more difficult due to drug interaction complications that could from HIV and TBD medications being administered at the same time.

2. How does substance abuse affect treatment of tuberculosis?

People who engage in substance abuse frequently while on treatment for TBD take longer to convert to inactive disease (TBI), become non-infectious, and to feel better overall. The body cannot absorb the antibiotics into the bloodstream because drugs like alcohol cause malabsorption. Drugs cause liver enzymes to be high, and if they remain high while on treatment for TBI, the healthcare provider will stop treatment until the patient stops illicit drug use activity. This can also lead to a form of drug resistant TB in the future if the patient does progress to active disease. Here at SCHD, we strongly urge that patients please refrain from any drug use while on treatment and within the future.

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Tuberculosis Control & Elimination

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1. What is the difference between tuberculosis infection and tuberculosis disease?

Tuberculosis infection (TBI) simply means that an individual has been exposed to TB and that person has the germ in his/her body but in inactive/sleeping state. Individuals with TBI are not contagious, so they cannot spread TB to other people. They also do not feel sick or experience any symptoms.

Individuals with tuberculosis disease (TBD) have also been exposed to the germ that causes tuberculosis but have a high number of TB germs in their body which are in an active state. Individuals with TBD are contagious and can spread TB from person to person if they have TB in their lungs or throat. Persons with TBD will feel sick and may experience one more of the symptoms of active TB.

2. What does a positive skin test result for TB and blood test result for TB mean?

A positive skin test result for TB means that a person has been exposed to TB and has the mycobacterium tuberculosis germ in his/her body. Although, additional testing is required to determine if an individual has progressed to active TB (TBD). A positive blood test for TB (QuantiFERON Gold) means a person has been exposed to TB and has the germ in his/her body. Additional laboratory testing and radiography are required to determine if a person has progressed to active TB (TBD).

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Tuberculosis Control & Elimination - Data Resource

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1. How many new cases of active tuberculosis does Shelby County average a year?

Shelby county averages approximately fifty new cases of active TB annually.

2. Can tuberculosis disease lead to death if left untreated?

Tuberculosis disease can lead to death if left untreated especially in individuals with co-infections such as HIV and TB, cancer and TB, Hepatitis and TB, and Diabetes Mellitus and TB. Other individuals may live although there is a high possibility that they will end up suffering from chronic prolonged illness which may eventually lead to death.

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Tuberculosis Control & Elimination - History

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1. Who discovered TB?

The agent that causes TB (mycobacterium tuberculosis) was discovered by Dr. Robert Koch in 1882.

2. Where did tuberculosis come from?

Tuberculosis has been around for thousands of years. Ancient Egyptian mommies have been found to contain the germ that causes TB. There is no way to exactly pinpoint tuberculosis’s origin. Although, history shows that it has moved along with mankind for quite some time and that it does not derive from animals like many other infectious/communicable disease causing agents.

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Tuberculosis Control & Elimination - Public Forms

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1. How do I get job clearance?

We do not provide job clearance at the SCHD Tuberculosis Clinic. In order to receive job clearance, a patient must make an appointment with his/her primary healthcare provider for an evaluation.

2. Where can I get tested for TB?

To find testing sites, visit our "Where Can I Get Tested for TB?" Page.

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Vector Control - Mosquitoes

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1. What can I do to control mosquitoes in my home?

There are a number of steps you can take in your home:

- Remove standing water where mosquitoes could lay eggs.
- Once a week, empty and scrub, turn over, cover, or throw out any items that hold water like tires, buckets, planters, toys, pools, birdbaths, flowerpot saucers, or trash containers. Mosquitoes lay eggs near water.
- Tightly cover water storage containers (buckets, cisterns, rain barrels) so that mosquitoes cannot get inside to lay eggs.
- For containers without lids, use wire mesh with holes smaller than an adult mosquito.
- Use larvicides to treat large containers of water that will not be used for drinking and cannot be covered or dumped out.
- If you have a septic tank, repair cracks or gaps. Cover open vent or plumbing pipes. Use wire mesh with holes smaller than an adult mosquito.

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Vector Control - Rabies Control

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1. What is rabies?

Rabies is a deadly virus that is transmitted by bites from an infected animal. Rabies can be prevented if treated promptly before symptoms develop. Left untreated, rabies is nearly always fatal. Although rabies in humans is very rare in the United States today, up to 40,000 people each year receive preventive treatment following an exposure.

2. What should I do if I am bitten?

If you are bitten by a wild or domestic animal, or get fresh saliva from the animal into a fresh wound or scratch, then immediately wash the wound thoroughly with soap and water for at least five minutes, and seek medical attention immediately. Local or state health officials should be consulted to help determine if rabies treatment is needed.

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Vector Control - Rodents

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1. Should I be concerned if I see a rat or mouse around my home?

Yes. Rats and mice are more than a nuisance; they can carry some very serious diseases. Everyone should try to get rid of areas around their home where rats can live, breed, and find food.

2. Do rats and mice spread disease?

Yes. Rats and mice can carry many diseases, including Leptospirosis, Plague, Rat Bite Fever and Salmonella.

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Water Well Permits

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1. What is a complete application set?

- An application completely filled out with all your contact information as well as the selected well driller information, signed by both of you
- A site map showing the well location
- A check made payable to Shelby County Health Department for the $25 application fee

2. What is the minimum lot size for a well to be installed in Shelby County?

A lot must be at least four (4) acres in size to have a well.