Community advocates and health groups are voicing concerns about the Sedgwick County Commission’s recent decisions involving the local health department. The latest public outcry came at the commissioners’ regular meeting on Wednesday.
The Sedgwick County Health Department is revamping some of its programs before more than $500,000 dollars in funding cuts take effect in 2016. KMUW’s Deborah Shaar tells us why the public health department has been forced to give up its lead role in some initiatives.
Inside the clinic at the Sedgwick County Health Department on East Ninth Street in Wichita, several moms are checking in for the Women, Infant and Children program, better known as WIC.
They’ll see a nurse or registered dietician who keeps charts on how the moms are doing with breastfeeding. Or, they’ll talk about healthy food options.
WIC is a longstanding program funded by the U.S. Department of Agriculture and administered by the Sedgwick County Health Department. When WIC funding was up for renewal recently, the program caught the attention of county commissioners, including 5th District Commissioner Jim Howell.
"The breastfeeding services, if they can be provided in the community through the hospital, through La Leche League, through private sector, through churches and neighbors and moms and grandmas, I would rather see it done that way if possible rather than through a government service," Howell says. "This is not something that used to be a part of this program."
Howell is rethinking how the WIC program is operating in the county. Eliminating WIC’s three part-time breastfeeding peer counselors was on the table at a recent commission meeting.
Those positions were spared--for now--but Howell joined two commissioners in voting to reduce the amount of funding the county will accept for the WIC program.
Health Department Director Adrienne Byrne-Lutz says this particular grant from the federal government pays for the staff at the county’s three WIC sites.
"It is a longstanding grant," she says. "We have had WIC funding for approximately 40 years, and this is a grant that is taken every year at this time."
This is not the first time this year that Byrne-Lutz will have to adjust to changes coming to longstanding health department functions.
The conservative majority on the county commission changed the role of the health department when it rejected federal and state grants for programs that target health issues such as obesity or tobacco-use. Then, in August, the county cut about $540,000 out of the health department’s 2016 operating budget. Now comes the WIC grant reduction.
"We are changing how we look a little bit and some of the functions that we have had," Byrne-Lutz says. "The positive and the important thing is that there are other community partners that are able to pick up some of what we are not able to do currently and provide those needed services to our community."
In 2014 Sedgwick County's was the second health department in Kansas to be awarded five-year accreditation by the Public Health Accreditation Board. But Byrne-Lutz says the “new normal” for Sedgwick County is a local health department that no longer will be leading several standard public health responsibilities. The budget cuts have run deep: Eight positions and two community health programs were eliminated.
"The impact was more on staff morale on seeing some of their colleagues and co-workers and then longstanding programs such as health promotion that is no longer part of the health department. That has been a difficult transition for a lot of people," she says.
The Health Promotion Program began more than 30 years ago, and up until recently, it included a worksite wellness initiative. The health department served as a resource by providing health challenges and incentives along with nutrition information to 70 local businesses such as Wichita Area Technical College and the accounting firm Info-Sync Services.
Info-Sync’s Human Resources Director Denise Christian says they always had a good employee response to the county’s wellness programs.
"We appreciated all those materials and information. It helped us keep the motivation going with the wellness program," Christian says. "We have very limited staff, creativity and time for that so it really kind of filled in those gaps and kept the motivation going with the wellness."
Some large businesses like Info-Sync Services already had a wellness program but used the county’s initiative for additional support.
Commissioner Jim Howell considered the Health Promotion Program “discretionary," and he says eliminating it was the right choice.
"The reason the health department exists, I think, is for people who are disadvantaged and maybe at poverty community that has no other place to go," he says. "They come to the health department for help, and we want to help them. And to me that’s got to be a higher priority than maybe a workplace health program that they can set up on their own."
The Health Educator Program is also ending. It worked closely with Wichita Public Schools to provide oral health as well as nutrition and physical activity education to students. Funding was also reduced to several other health department programs such as immunizations and cancer screenings. These services are still being provided--with a catch. There are fewer support personnel and medical assistants there to help.
"We are going to be tracking wait time, particularly during peak seasons like back to school and flu season, just to see what the wait time is and how much any of those services are impacted," Byrne-Lutz says.
Another impact of the cuts: The health department lost the lead position for the Community Health Assessment. The assessment is done once every three years and helps determine the major health problems in the county. The last time this was done, five priorities were identified: access to health care, obesity and diabetes, oral health, mental health and health disparities.
Commissioner Howell says the assessment has value, but questions the lengthy process involved.
"I’m not saying we shouldn’t do this to some degree at some point in the future, but to do it every single three years and never stop the process of collecting data, doing the analysis and rewriting the document? I guess my opinion is, it’s not as valuable as maybe the medical establishment thinks it is," Howell says.
The health assessment helps guide the development of a Community Health Improvement Plan, essentially a roadmap of strategies and resources to address the priorities. The current plan runs through December, and a new plan is expected to come out early next year.
The Sedgwick County Health Department will still be involved in the assessment process in the future, but come January will transition to a new back seat role of “partner” instead of “leader.”
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Follow Deborah Shaar on Twitter @deborahshaar.
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