COUNTY HEALTH AGENCY TURNS 10

A decade ago, the bulk of business for the Cape Girardeau County Health Department consisted of nurses visiting elderly patients and giving immunization shots to toddlers.

But times have changed.

In the 10 years that the department has been operating, the focus of public health and the role of health departments have expanded to include a large dose of education, prevention and policy-making.

This is Public Health Week, and Charlotte Craig, director of the Cape Girardeau County Health Department, looked back at the changes that have occurred since voters first approved a tax to fund the department.

In 1986, Cape Girardeau County voters approved a mill tax to fund operation of a health department.

Up until 1986, services were offered by the county nursing service. Most of what the nurses did were home visits for Medicare and Medicaid reimbursable care, and immunization clinics.

That same year the home health industry was deregulated and the health department stepped out of this part of the home health business.

"Public health is traditionally known for finding a hole in the dike and providing the service," Craig said. When someone else steps in to provide the service, public health usually moves on to the next project.

While nurses with the health department still make home visits, the scope of services offered by the department has exploded.

In 1989, the health department moved to a new 10,000-square-foot building.

"I can remember walking around this building and marveling at all this space," Craig said. Today, every square inch of the building is used, and Craig has turned down state-offered programs because she has nowhere to house them.

As the department moved to its new facility, less than 10 employees worked for the department. Today, the health department employs 38 people.

In the early years, much of what the department did was clinical -- immunization clinics, sexually transmitted disease clinics, and home visits.

Components of education, prevention and policy-making now make up the bulk of health department business.

For example, the department has been instrumental in policy-making through CHART, Community Health Assessment Resource Team.

The health department teamed up with other community agencies and organizations to find out what health care needs are unmet.

The first program from the CHART is implementation of The Health Line. People can call for information on hospitals, clinics, physicians, support groups and other health-related topics.

The department conducts inspections of area restaurants and food schools to teach cooks and waiters the proper way to handle, prepare and serve food.

Sanitarians are working to ensure proper installation of septic tanks.

The department can issue temporary Medicaid cards for pregnant women, giving them time to apply for permanent Medicaid coverage.

Craig is working on a county ordinance concerning animal-nuisance abatement. She is also working with the county emergency operations center to prepare for future disasters like tornadoes, earthquakes or chemical spills.

The department is active in a program to educate teens about postponing sexual involvement. It issues birth and death certificates, conducts cancer and lead screenings.