The Reality of Facts: Is the Lubbock Health Department Closing?

Transcription

1 The Reality of Facts: Is the Lubbock Health Department Closing? Socrates told us, it is not reality that troubles us, it is how we view it. For over thirty years as a psychologist I have worked to appreciate the reality of those I have worked with. To appreciate how dysfunction can have a function and how people find balance in their lives. As regards the current debate about the future of public health services in Lubbock I believe that almost without exception the leadership of our community has worked diligently to understand the question put forth by the city manager in July. Each view point desires to strike a balance between fiscal responsibility and compassionate care as we grapple with how best to provide for our citizens. Last Thursday, October 6th, the specially appointed sub committee of the Lubbock Board of Health concluded their mission. A resolution was passed unanimously that the city government must remain the central administrator of public health. Discussions among the sub committee members however left much unanswered about the specifics of how to provide this essential government service with each member voicing an interest in the need for further definition of how best to proceed. On Friday, October 21 th, the sub committee s report will be presented to the larger City of Lubbock Board of Health at their regular meeting (12:30 start, location is the Health Department Building located at 19 th and Texas, public is invited to attend). At this meeting the public will again have their opportunity to shape the recommendations of the Board which will be directed to the City Council shortly thereafter. It is important to remember that the Board of Health does not have any authority beyond recommendations to the mayor and council. I speak for the majority of the Board of Health membership in that the issues presented and discussed up to this point are far from decided and that it is our intentions to continue to offer information and review before a consensus and recommendations are offered from our Board. In the last two months I have labored in finding respected research that provides a review and forecast of the public health services in Lubbock. The result was an 18 page paper with two pages of references that was presented to the sub committee last Thursday. My presentation, along with several cited national organizations and their recommended standards for public health, was not extensive reviewed due to strict sub committee guidelines that were imposed. At the Health Coalition of Lubbock meeting (which took place immediately after the sub committee meeting last Thursday) over 100 citizens were advised and provided feedback about the actions of the sub committee and the group responded with the initial response in the next phase of the debate. Today, the County Medical Society was allowed to publish their recommendations about this matter in the Lubbock Avalanche Journal. This organization, whose members include over 600 physicians in Lubbock, took the position that attempts to alter the service structure of the Health Department were unacceptable and other solutions needed to be found. Given the disinterest of the city government in developing a more complete understanding of the role of public health and the necessary components it is clear that further public information campaigns

2 have to be activated. The County Medical Society has provided over 4,000 pre printed postcards which will be used in presenting the issue to the Mayor and City Council. The Coalition will soon begin to conduct block walks across the city where citizens will be asked to provide a personal response using the postcard which will be forwarded to their representative among the citizen leadership. So far, the Coalition has collected over 6,000 signatures on both our on line and hard copy petitions asking that the city not out source or otherwise change the existing health department services. The Coalition is accepting of the need to evaluate the Health Department structure and process but does not agree that money is the driving factor in how decisions are carried out. One man s truth is another man s lie and the two polarizing views involved in this current debate result in very different conclusions. I will not argue the point of finances as the other side has demonstrated their singular drum beat of how the city must cut back and reduce programming. The recent actions of the city council to restructure CitiBus services speaks clearly to those with such motivation. The most relevant point that clarifies what is the reality of the Mayor and City Council is that the simple provision of medical care is being equated or portrayed the same as what occurs in a fully functional public health system. Those who wish to out source STD, immunization, and other health department services have repeatedly cited their opinion that nothing will change and services will not be interrupted or otherwise become more difficult to obtain. In the opinion of the Health Coalition such a statement that the Health Department will continue as before are not supported by respected research. No individual from the ranks of local physicians or other health care providers have publically come out in support of the city s plans. In my presentation I noted a variety of studies that found evidence of problems associated with the proposed actions of our city manager. If the proposed action to transfer clinical services is carried out there will be significant drops in vaccination rates among seniors and children; our top rating in sexually transmitted diseases will spike with the resultant misery of lost health and; our citizens will be directly placed into a more significant risk for both seasonal and crisis based epidemics. The Health Coalition needs your help in establishing the reality that best promotes and protects the health of our community. Our first goal is to send a strong and clear message to the Mayor and City Council that action is indeed needed but not that which was proposed as this will gut the existing services. There is much work needed and The Board of Health is prepared to lead the way. We must separate out political and clinical factors in public health so that services are not denied based purely on the whims of those who influence politics but are the result of knowledgeable and informed independent guidance from the health care and scientific sector.

3 Recommendations of the Health Coalition The current recommendations from the Health Coalition that will be submitted to the City of Lubbock Board of Health for consideration and action includes: For the city to generate and realize a vision for the health of its people, commitment and broad active participation by the city and county government are essential 1. In recognition of the impact that the entire range of city and county agencies activities can have on the health of the city and county there is a need to establish an Interagency Council on Health, with a joint city county Health Department as the designated lead agency. It is essential that the Health Department be guided at all levels by professionals educated and well versed in the science of public health. 2. The Coalition believes that it is important that there be the development of a three year health plan with explicit priorities, city wide objectives and proposed public and private programs with this being a high priority for the city and county. The objectives should be framed in measurable terms, so that their accomplishment is easily assessed. While the existing Health Dept has developed state of the art response plans for emergency circumstances the reduction in staff and educational services over the last few years has left little consideration for the general health of our community. This is the reason for this need for a more broadly based plan of health goals. The plan should be developed in extensive consultation with the city s communities from the very earliest stages, and it should also be subject to community hearings. As education is a primary goal in public health there must be a committed effort to engagement and transparency in the process. Community involvement in plan development should be a structured process that engages broadly representative structured community bodies. 3. Regarding surveillance the city should give full financial and policy support to the completion of the steps needed for integrating the Health Department s surveillance programs and making available comprehensive community health profiles at the lowest feasible geographic level. This would likely call for a return to a fully staffed surveillance team in order to meet the minimal standard of care to carry out their mission. 4. The Coalition does not support any fragmentation of Health Department services and believes that the STD, surveillance, and immunization should be restored to one central

4 location. Furthermore, the Coalition believes that Health inspections, vital records, and the BSL III lab should remain within the Health Department in that same central location. It should be understood that the above recommendation to restore ALL existing services back within the Lubbock Health Department is not at odds with the resolution that was passed by the Board of Health at their August 2011 regular meeting. While the first set of meeting minutes showed that the Board accepted the relocation of services these were corrected at the September Board of Health meeting to reflect the Amendment made by Board of Health member Kay Henges that further study was needed before the Board would give support for ANY relocation of service. 5. If the present Health Department location at 19 th and Texas Avenue is determined by the Board of Health to be insupportable in continued clinical operations the Coalition is supportive in identifying a new centralized location for services to be operated from. It has proven difficult for either the Coalition or the Sub committee of the Board of Health to gain a clear understanding of the financial cost of operations. Thus, the question of relocation remains open at this time until these budgetary numbers can be adequately understood. 6. The Coalition recommends that restoration of an educational outreach service arm of the Health Department is vital to the mission of public health and should be restored. The decision as to how best to accomplish educational objectives should be under the control of knowledge clinicians familiar with the areas involved and not controlled or otherwise restricted by city leadership based on political factors. 7. Recognizing that budgetary considerations must be factored into the operations of the Health Department the Coalition supports the establishment of a 501c3 non profit entity (similar to what has occurred in Amarillo) in order to raise funds for use in public health campaigns and service delivery in other operations of the Health Department. 8. As to the question of other financial support for the operation of the Health Department it is assumed that it is not the purpose of the Board of Health or the Coalition to clarify where monies are to be drawn from. Much as with other essential government services such as fire and police departments it is understood that these must be maintained and funding will be provided. The Coalition believes that it is the mission of the City Council to identify sources of funding for essential public health services and that city staff is better equipped and charged with examining how best to fund said operations.

5 Action Time Line: What Every Citizen Can Do to Help The following Health Coalition goals are identified as: 1. Continued collection of on line petition signatures from the Coalition web site located at 2. Collection of signatures on the hard copy petition using block walking in all parts of the city, with particular emphasis on Districts 5 and 6 (Karen Gibson and Jim Gilbreath s districts). A view of this voting district map is available on line in PDF format at Volunteers are greatly needed in this effort and please contact Dr. Brian Carr if you can help at bha@healingtalk.com or office telephone (you may need to leave a message and I will call you back). We will have a sample script to use as well as the pre printed postcards and address labels. We hope to start these block walks the week of Oct 18 th and continuing through November. 3. We ask citizens to attend the next Board of Health meeting set for October 21 st at 12:30 p.m. at the Health Dept located at 19 th and Texas. Remember that, if you wish to interact with the Board you must sign up by 5 p.m. on Friday, October 14 th with Bridget Faulkenberry by contacting her at BFaulkenberry@mail.ci.lubbock.tx.us or by telephone at If you only wish to address the board without interaction you only need to sign up just prior to the meeting. Even if you have no desire to speak at the meeting we must have public participation or the city leadership will think that support is faulting. Please attend. 4. If you would like to contact your council member directly the following is their information: a. Mayor Tom Martin TMartin@mail.ci.lubbock.tx.us b. Councilman Victor Hernandez VHernandez@mail.ci.lubbock.tx.us (806) c. Councilman Floyd Price FPrice@mail.ci.lubbock.tx.us (806) d. Councilman Todd Klein TKlein@mail.ci.lubbock.tx.us (806) e. Councilman Paul Beane PBeane@mail.ci.lubbock.tx.us (806) f. Councilwoman Karen Gibson KGibson@mail.ci.lubbock.tx.us (806) g. Councilman Jim Gilbreath JGilbreath@mail.ci.lubbock.tx.us (806) h. The surface mailing address for all the city government is: th Street Lubbock, Texas After the Board of Health receives and reviews the sub committee resolution they will then draft a resolution that will be presented to the City Council at either their November or December meetings. The 90 day moratorium that delayed the proposed city action will expire on 11/25/2011. As the issue is placed on the agenda for the city council we will advise of the

6 time and date and ask that we generate another large crowd in the council s chambers as the matter is discussed. I speak for the Coalition when I gave a BIG THANK YOU to all who have committed to participate in this critical moment in our community s health. While some have vocalized strong opposition and personal attacks against members of our Coalition the overwhelming support offered for our position is much larger. However, make no mistake, the opposition is counting on you and I to be distracted with other matters and fade from the struggle. Together we can help not to just save our Health Department but to initiate a conversation about how best to further develop care for each other. That is all. Keep the faith. Contact me with any questions. Brian D. Carr, Ph.D. Licensed Psychologist Secretary, City of Lubbock Board of Health Member, Health Coalition of Lubbock bha@healingtalk.com office