In her offer to receive a portion of the county’s federal aid dollars, the Dubuque County’s Department of Health chief executive suggested hiring three full-time employees to help tackle the disparities she believes have been emphasized by the COVID-19 pandemic.
Patrice Lambert said she saw her chance to finally grow her department and services with a portion of the nearly $ 19 million the county is receiving.
“Even before the pandemic, we couldn’t fully focus on the 10 essential public health services due to staff shortages,” she told the Telegraph Herald.
As defined by the Federal Centers for Disease Control and Prevention, these services include assessing the health of the population and the factors that affect it, diagnosing and treating health problems, mobilizing partnerships to improve health, implementing guidelines and laws that affect health, the application of legal action and regulations to improve and protect health, and develop a diverse and qualified health workforce.
“We have to look for equity and try to coordinate health and social services,” said Lambert. “The health and well-being of our Dubuque County residents is affected by much more than just medical care – the environment, housing problems, transportation, access to healthy food.”
The county health department currently consists of Lambert, deputy director Samantha Kloft, environmental health specialist Collin Dolphin and part-time worker Bailey Avenarius.
Lambert’s proposal would add three more full-time employees – a lifestyle specialist, a health care oversight specialist, and a community education and public relations specialist – and make the clerk full-time. County Supervisor Ann McDonough estimated the moves would cost an additional $ 400,000 annually.
The additions would allow the department to focus more on areas officials have wanted to address for years.
“We’re already looking at these components, but we’re only touching the surface because we know there are so many drawers underneath,” said Lambert.
She gave drug abuse as an example.
“We know substance abuse and opioid use are still a problem,” said Lambert. “But we don’t have anyone who can ask another committee to look at the data.”
That would be a focus of the health services regulator.
“You would work with such projects, but also a lot with our health authorities,” said Lambert. “If (schools) see obesity rising on school exams, they would contact us in October and say, ‘We see obesity is on every chart.'”
This position would also help continue and strengthen the connections with health care providers, including brain health care providers, formed during the pandemic.
The community education and outreach specialist would help coordinate with partners across the county – including local governments, schools, and businesses – to educate the public on health issues. Lambert said her department had problems with this in the past.
“When we brought our radon test kits with us, I emailed the city officials and asked, ‘Can you help us (apply)?'” She said. “Then it was about them saying ‘yes’ or ‘no’. We didn’t have time to expand the pedagogical component of how important it is. “
The lifestyle specialist would conduct health needs assessments on site and for the state and collect data on diet, nutrition and physical health. The person would also act as a liaison between the division and the Dubuque County’s Food Policy Council – work Kloft is doing now.
The Kloft Assistant Director position would focus in part on grant writing and budgetary affairs for the department.
District overseers recently approved a contract with Limestone Bluffs RC&D to serve as staff on the food policy council, including reporting periodically to the board of directors.
The county also just renewed its contract with the Visiting Nurse Association for $ 308,000 this fiscal year. The association acts as the front line of the district health office. VNA Director Stacey Killian said the equivalent of 30.8 full-time employees adds to the work for Dubuque County. These employees provide vaccination clinics, oral health services, sexual health work, and adult health education.
The county health departments vary in size and shape across Iowa.
The VNA acts as Clayton County’s entire health department. Jackson County has two full-time and one part-time healthcare workers. These counties have a fraction of the Dubuque County’s population.
Among counties closer to the Dubuque County’s population, Story County is fully outsourcing its public health functions to Mary Greeley Medical Center in Ames. Pottawattamie County has all services in-house, including a clinic.
This is just one of the things regulators will be looking at before allocating American Rescue Plan Act money to their decisions in November.
McDonough liked Lambert’s needs analysis, but questioned whether the Department of Health’s proposal met the goals of the federal money.
“What you are proposing is 3.25 permanent employees … another roughly $ 400,000 annual budget,” she said. “Well, the expenses you are proposing will be borne by the rescue fund, the budget for it will not exist in the long term.”
If the funds can be used to initiate this expansion of their department, Lambert said, the resulting employees could then look for grants and other programs to help cover the costs.