Carolyn L. Higgins – Contributing Writer
Public education and partnering with community entities topped the list as high priorities during the April 24 Macon County Board of Health meeting. Reports were unfolded showing increases in communicable diseases, new grant opportunities for community providers and budget requests reflecting continued, proactive engagement and increased services.
Communicable Disease Report
Communicable Disease Coordinator Rachelle Castle of the Macon County Health Department reported that STD (sexually transmitted disease) numbers show a spike in Macon County. There was a 51 percent increase in Chlamydia and a 23 percent increase in Gonorrhea and the numbers could be higher.
“The diagnosis is based on clinical manifestations and in-house lab reports, so [the cases] are probably not being reported as often as are actually occurring,” said Castle. Hepatitis C is also being watched carefully. People not getting vaccinations, more overseas travel and an increased immigrant population are some causes. The department monitors reportable conditions, ensures public education is provided and that proper treatment recommended by the CDC (Centers for Disease Control) is administered.
Community Health Assessment
Every three years the department conducts a community health assessment, pulling together data on any health risks or concerns and utilizing 500 different sets of data. “We review all that and we work with the leadership team, and the Western North Carolina Health Network which is the group that is sponsored by hospitals in the Western N.C. region,” said Lynn Baker, Population Health Section Administrator. After narrowing data and analyzing the top 15 to 20 health risks, the department then works with community stakeholders to arrive at the top three health priorities. Task forces were established to work on those items that were identified as heart disease, domestic violence and economic development as it relates to health.
The overarching umbrella is called State of the County Health Report (SOTCH). “SOTCH is like a progress report on where those groups are, where those task forces are, what they’ve been working on . . . the progress they’ve made,” said Baker. The Health Task Force is still going and concentrates on worksite wellness promotion in preventing heart disease, and another task force is looking at response to mental health and behavioral health issues.
Health Director Jim Bruckner said he would like to get everyone working with the CDC Work Site Score Card. “We’ve done it here and with three other companies, and we’re trying to get everyone else to do it,” said Bruckner. Bruckner and Baker agree the community must be involved as research and evidence has shown it takes others beyond the health department for the community to see the biggest change.
Operations Supervisor Tammy Keezer shared the budget, noting Bruckner completed some additional negotiation, resulting in total requests of $236,533. She presented requests for $62,000 to replace two environmental health vehicles and $76,000 to replace two animal control vehicles and a box. The vehicles have high mileage and/or numerous repairs and the county fleet manager had recommended replacement. One animal control vehicle needing replacement was not approved last year but has been out of service.
Money was requested for retirements in the amount of $21,533, pending rumored retirements. Any vacation payout due at time of departure and longevity pay must be prorated per records at time of departure.
Additional funds of $70,000 were requested for the dental, electronic health records (EHR). “We have to implement the dental EHR by June of 2019. So, we have no choice now but to buy it,” said Keezer. Adult Dental Capital has requested $7,000 to replace an autoclave for that clinic.
A Medical Access Grant for $43,000 was applied for again, but not in the budget, because it came in after the budget was submitted last year. It is not included because it is not guaranteed. The $150,000 Community Health integrated Care Grant for primary care and prenatal health combined is included in revenue. The asthma grant is included at $4,000. In addition to that, overall revenue was increased $99,000, if those grants are included.
“We asked for $99,000 in new revenue, but requested increase to the county net cost is only $38,000 [over last year’s budget of $2,658,649]; and we have well over $200,000 at one time requested at the moment,” said Bruckner. “Which means we absorb most of that into the current and existing budgets. All the rest is pretty much the same amount of money — $38,000 more overall in county funding.” The proposed budget increase was approved by the board and set to move to the Macon County Board of Commissioners for approval.
New or Reapplication Grants
Bruckner presented four grants that have been submitted or are in process.
1) The Work-site Wellness Grant is through 1422 Mountain Wise Regional Project that is focused on automotive industry providers. The Appalachian Regional Commission has applied, but each county must apply for their share of the $1.6 million. The department is seeking a $78,000 grant. 2) The Integrated Care Grant through the N.C. Office of Rural Health provided $150,000 last year, but the department, like all applicants, must reapply each year to show objectives have been met.
3) The Maternal Health Grant provided $42,500 last year, and the department is reapplying because it was done mid-year last year and they didn’t go through the Office of Rural Health’s normal process. “This year we are applying for $50,800 for the Health Department, and we applied for $99,200 for Blue Ridge Free Dental Clinic to support their staffing up there,” said Bruckner. “So we are applying for $150,000 of which we will fund their programs up there.”
4) The department is named in a East Carolina University grant to bring Tele Psych to the health department, but is not actually named in the grant as ECU is the applicant. The grant will pay for all the equipment and will pay for three to four hours of psychiatrist time a week for a year and allow for additional psychiatrist time at Macon County.
Permission to receive the grants was approved by the board. The Quarterly Budget Update showing red only because some state monies need to be drawn down and some revenue for services billed has to be realized, was also approved. Finally, the billing guide with only changed wording for determining environmental health and animal services fees was approved as well as the new schedule that only had changes for women’s colposcopy lab tests and labs for animal services.
Bruckner closed by offering anyone an opportunity to review the four-inch thick binder at anytime by scheduling at least a three-hour time slot.