Health department turf battle brewing?

McCOOK, Neb. — The director and public health nurse of the Southwest Nebraska Public Health Department questioned Red Willow County commissioners Monday morning about their intentions to let the county’s health department work beyond county lines.

Myra Stoney, SWPHD director, and Melissa Propp RN told commissioners they have had a good working relationship with the county’s health department and were surprised two weeks ago that the county’s health department is considering providing services in areas that SWPHD covers outside of Red Willow County.

During a budget hearing with commissioners Aug. 27, county health department board president Kevin Potthoff said that as a revenue-generating possibility, the county health department could provide its services in neighboring counties, if they are requested. Commissioners told Potthoff and health department director Pam Harsh that if the health department were to work outside Red Willow County, absolutely every dollar of the expenses must be covered by the out-of-county entity, that the service must generate revenue for Red Willow County, that they cannot spend Red Willow County taxpayers’ money out-of-county if it doesn’t generate revenue for Red Willow County.

Propp asked commissioners, “What can be gained by going into counties that are already served?”

Potthoff said Monday the county’s health department should be allowed to go into another county “if solicited. IF solicited.” Commission chairman Earl McNutt agreed to a point: “IF someone requested the service. But I didn’t want you going shopping” for business.

Stoney said that two years ago, then-commissioner Vesta Dack instructed the county health department to stay within county borders. Stoney asked if other Red Willow County departments cross county lines without an agreement of some sort?

Why is it okay for one department to cross county lines, she asked. Potthoff stressed again, “IF we’re solicited.” And McNutt reiterated, “We don’t want you to go looking for work outside of the county.”

Potthoff said that as a way to increase revenue, to sustain the county health department, “IF solicited … maybe we got the okay?”

Potthoff continued, “The driving force here is, we’re short revenue.” He said, to Stoney, “We still want to be here, if your tobacco money goes away.” He said the county health department was in existence before the SWPHD. Many regional public health departments across the country, including SWPHD, were created through a $205-365 billion Master Settlement Agreement between the federal government and four major tobacco companies in 1998.

Stoney said that SWPHD is not funded with local taxes, and that the “tobacco money” is federal and indefinite and the funding is perpetual.

Propp said that SWPHD covers nine counties, including Red Willow County. She said, “Red Willow County does a fantastic job. SWPHD does little in Red Willow County because it’s covered.

“And we’re willing to work collaboratively” with the county health department, as she said they have done in the past on vaccines and immunization programs for children and adults with the county health department’s immunizations coordinator Pam Klug.

Commissioners took no action. McNutt told the two groups to “keep the lines of communication open.”

———

Stoney said health departments strive to meet immunization guidelines set by the federal Health and Human Services’s “Healthy People 2020” program, including having 70 percent of children 6 months through 17 years and adults 18 and older vaccinated against influenza. Stoney said, “There’s a big gap between where the feds want us to be and where we are.”

Propp said to meet the 70 percent goal, evidence shows success with adult immunization programs that go to local granaries to vaccinate farmers as they wait in line; that offer vaccinations for business and school employees at work; and that go into places of worship.

Stoney said the Dundy County Hospital in Benkelman has success going from business-to-business to give flu shots.