Health Director list goals for 2008
By Phyllis Moore
Published in News on February 26, 2008 2:00 PM
Improvements have been made in the way the Health Department does business, but some areas -- obesity, chronic disease and communicable diseases among them -- still need work, Health Director James Roosen recently told the Board of Health.
His staff is currently juggling completion of the 2008-09 budget while complying with benchmarks required for the Health Department to become accredited, he said.
It's been a time to review progress made, with an eye toward the future, Roosen said.
Communicable diseases, particularly the sexually transmitted variety, need addressing in the coming year, he noted.
"We're averaging 196 patients a month in our STD clinic," he said. "The goal for 2008 is to have an HIV/AIDs case manager. ... (because there are) 220 to 240 people in Wayne County who are HIV positive and not in a system of care. That's dangerous. They should be linked to a doctor who's making sure they're complying with a control measure, getting their medicine to control their viral loads."
The staff position would help strengthen the investigation and reporting of communicable disease, he explained. With the more rapid testing now available, results could be more readily available and shared.
"About 25 percent of people who have HIV are not aware of their status," he said. "Mainly we're doing it just for surveillance, to find out their status. We can issue a control measure, get them some help."
Roosen told the board he is looking for a community-based organization with an interest in testing "folks who otherwise would be untested" as well as a site. Partnering with the community could also lead to grants, prevention and "marketing public health to potential patients and employees," he said.
As part of his year in review, Roosen cited areas where progress has been made.
One of those was staff turnover.
"A year ago we stood up and said we were having a drastic problem with turnover in Environmental Health," Roosen said. "We made some adjustments, rewarding our employees. ... The only turnover we have had this year are two people who have retired and they had already retired once before, but we don't have people jumping ship to go elsewhere."
The previous year, he said, 28 people left the Health Department. This year, there were 18.
"That's important because of the expense of training these folks," he said.
Board member Efton Sager asked if exit interviews were conducted to discern reasons for the departures.
"About 70 percent cited salary as the reason but it's not the sole reason," Roosen said. "A lot of people made a commute and found something closer to home."
Competing with hospitals and other health care providers has contributed to the situation, he said, but salaries are also "an important part of that."
Creating a quality environment at the Health Department is vital to staff as well as clientele, he said.
With increased caseloads -- Women and Infant Care saw a 24 percent increase over the last four years -- "modified open access" improved efficiency, Roosen said. The scheduling measure decreased wait time and moved patients through the prenatal visits much quicker, he added.
Reviewing practices and procedures provides insights into "opportunities" for the future, Roosen told the board.
In family planning, for example, 641 births to teens have been reported over the last three years, with 189 abortions to girls 15-19 reported for the same time period. The teen pregnancy rate in Wayne County, meanwhile, is 7.1 percent as compared to the state rate of 6.3 percent.
"We're seeing a lot of unplanned pregnancies so there's definitely some opportunities for partnering with other agencies -- WAGES, Department of Social Services -- that have their hands on these patients, maybe refer them to (our) family planning," Roosen said. "One of our goals is to partner with them a little better."
And while infant mortality rates have decreased, Roosen said there is still a need to "identify these women at an earlier stage of their pregnancy, get them in a system of care as soon as we can."
Obesity and chronic disease were also mentioned.
"Chronic disease accounts for about 70 percent of health care expenditures in the United States," Roosen pointed out, citing a study done by Blue Cross Blue Shield. "About 26 percent of adults in North Carolina are considered obese."
Lifestyle modifications could tip the balance and improve those statistics, he added.