The future of public health
As the future of public health is being determined by community need, state standards and the possibility of budget cuts, many area health departments plan to share responsibilities with area health providers and with each other.
Washington Public Health administrator Edie Nebel said that health departments are in a transition now. She said the Washington County Health Department has recently completed a study to determine what services are being offered, what may be redundant with other services in the community and which services are needed.
“The future of public health is to look around and figure out what you do well and share with your neighbors, rather than everybody creating the same thing or creating a different version of the same thing,” Nebel said.
In the past, she said, county health departments were very service-oriented and focused on grant funding for those services. While she feels some direct services will be required in the future, she said that health departments will be required to fill gaps in services offered by other health care providers. Health departments will also look at other departments around to determine who has services that can be offered.
Additionally, she said, there is a new program of state standards being implemented for county health departments. While not mandatory, Iowa Department of Public Health Modernization Coordinator Joy Harris believes incentives will be given to county health departments to implement the suggestions. She said the goal is to ensure a minimum of health care is provided to all Iowans. She also said local health departments will be asked to become accredited, which means that they are recognized for providing at least the minimum of care required. The 11 standards will be explored in part 3 of this series. No county is currently accredited at the state level.
The Washington County Health Department is now attempting to secure funds to build a $2 million building in Washington for its department.
Washington County Health Department public health program director Chrystal Woller said, when asked if a new building is premature before the department knows what standards are going to be imposed, that the public health department is flexible in its use of space available. The Washington County Board of Health is evaluating space available at the Washington County Hospital to house the health department.
“There will be changes in the way we do business with changes in the modernization of services. Everybody should expect the same level of service no matter what county they reside in. However, services in larger counties may be more extensive because of more money (funded to larger counties),” said Linda Albright, director of Henry County Health Department.
Chris Estle-Tedrow, director of the Jefferson County Health Department, said she understands why it is important to have standardized services, but it could create hardships for some.
The county health departments could be more proactive in prevention and be used as a resource center for information and care coordination.
“It sounds great, but where will the money come from?” she asked.
She said there have been discussions on reorganizing the health department, similar to the way ISU Extention and area education agencies were reorganized. “But counties might not want to find another county. … We’ll see what happens.”
Nebel said in the future, she believes each county health department will identify areas they are strong and weak in, then look to their neighbors for aid in weak areas. She believes Iowa doesn’t need 99 counties with 99 identical health departments.
“We are kind of in a transition now, from an independent way of thinking and giving services that have always been done by public health to looking at a more indefinite process and looking at what we should be doing and if we are needed to do some of the things that have always been done,” Nebel said.
The Washington County health department recently completed a strategic plan. The reason is to determine what services are required and to align with community health providers.
Albright and Jodi Sutter, environmental health specialist, are both involved with Quality Initiative Champions. There are 30 local public health professionals and 12 state public health staff members taking the course. The group met for two days in October and will meet again for two days in January. In the interim, there are several webinars for the group.
Albright said that standardization will allow people to know more about what is available in the area.
Estle-Tedrow said what happens in public health depends on what the party in power sees as a priority, and it trickles down to even the board of supervisors because the supervisors appoint the board of health. “Politics are everywhere,” she said.
Albright disagrees, saying the local board of health determines most decisions on services offered and state codes for the governance of health department are already in place.
Jefferson County Public Health doesn’t want to relocate from its offices in the Fairfield fire station. “We love our space,” said Estle-Tedrow.
For the full story, see the Nov. 29 edition of The Washington Evening Journal