Health Department Advisory Board Report

Public Health Department Advisory Council Report
August 28, 2013   4PM

As the Affordable Care Act reaches the beginning of its major
program, that of providing and requiring insurance coverage, a
number of health related and insurance related programs have
been provided in Manhattan.

Manhattan Alliance for Peace and Justice, i.e. MAPJ had at their yearly “Health Forum” the new administrator of the Riley County Health Department, Brenda Nichol who spoke about the many health
related programs available at the Health Department.  She used a power point presentation to support her discussion and suggested
that all of this information was available at their website and that they are also using Facebook. She listed the public health
services that are supposed to be provided, some by state or federal mandates, by all Public Health Departments and discussed how the Riley County Health Department carries out it’s mission,
systematically going through all the divisions of the Health Department and their specific programs. For example, there are 40 staff which of course make up the major costs for the Health Department. I have taken from the web site a list of the services that make up Public Health in the US which suggests the scope of the mandate to any Public Health Department.

“There are Ten Essential Public Health Services all local public Health Departments should undertake in their communities:
Monitor the health of the community 
Diagnose and investigate health problems 
Inform, educate, and empower people
Mobilize community partnerships
Develop policies that protect and promote the health of the community
Enforce laws and regulations
Link to/provide health services
Assure a competent workforce
Evaluate quality of services and programs
Research for new insights into improving health”


    Sandy Praeger, Kansas Insurance Commissioner, was the speaker for the September, 2013 Lou Douglas Lecture held at the K-State Forum Theater on September 10, 2013.  She began with
an interesting history of the many attempts by the United States Government to provide universal
health insurance dating back to 1913.  It was after world war II that businesses, in order to attract
employees, began to offer health insurance as part of their pay to prospective employees.  Congress went along with the idea and made concessions on taxes to employers who offered health insurance.  This is how health insurance become attached to employment, for better or worse.  Most other nations do health provision individually related to taxation.  The ACA (Affordable Care Act)  builds on the employment related model while also offering individual
insurance through the insurance “exchanges” now called “Marketplaces” provided for those not receiving Health Care at their place of employment.  Since the Act wants everyone to buy insurance,  thereby spreading the risk in the usual insurance plan way, the plan offers a number
ways to mitigate the cost of individual insurance for those who qualify.  Ms. Praeger noted that
there is much misinformation and misunderstanding of the ACA and so her department is planning many programs throughout the State to explain the program and encourage people to participate.
    As might be expected, there were many students in the audience and unlike many such
lectures, they did not leave at the end of the lecture but stayed to ask many questions.  Many wanted assurance that they could stay on their parents insurance until age 26.  Also of interest
was the requirement that no prior existing health problem or cutting off of health insurance at a monetary level was truly in effect.
    In discussing the development of the “exchanges for buying individual insurance” as mandated by the ACA, states,  34 of them, who opted out of developing their own insurance exchanges, will be working with the federal government, but at the same time each state has its
own laws related to insurance, so at this moment, KHHS is working with the federal exchanges to be sure they fit with the Kansas laws.  The ACA was passed by a Congress insisting that States be the ones to administer the law.  Ms. Praeger’s discussion, I felt, made the issue seem much less complicated than much of the Media suggests.


The Advisory Council meeting was attended by only four members, Dr. Paul Hesse, Ginny Barnard,  Michael Cates, and Karen McCulloh.  Adam Bowman, who was to discuss the satellite Dental Clinic housed at the Health Department was unable to come  so a wide ranging discussion took place rather than a regular meeting.  Brenda Nichol , Health Department administrator,  began a discussion of accreditation and of planning for a community health needs assessment which seems to be a definite plan in the works.  There is also a plan to seek a grant for the Riley County  Health Foundation to do an assessment of social services in Manhattan.  These surveys complement each other.  Karen McCulloh thought that along with the surveys there could be some education added in which seems to be much needed.  Brenda mentioned her opportunity to
present at the MAPJ Health Forum and especially mentioned that Commissioner Ron Wells was
there and Representative Sydney Carlin which she thought showed good interest in the Health Department. Brenda also emphasized that she had begun substantive meetings with the supervisors and are meeting regularly and looking at development and innovation in the activities of the department. There are also some students coming to the department as interns from the nursing and social work programs such as at Washburn.  Weekly reports are being sent out to all the staff and to others interested.  The Department   heard from the United Methodist Church in St. Mary’s where for 19 years the department has held their mobile clinics  that that space was no longer available.  Lisa, supervisor, was told that the church was “no longer going to support services like ours.”  A new space will have to be found.  Rent is paid through September so there is some time to look for another place.  Lisa reports that that clinic serves the smaller northern towns in that area and there are often large families who come.  The focus of the clinic is Women, Infants, and Children.
Since the Primary Care Clinic has been unable to find a suitable midlevel provider such as an ARNP or a PA there is considerable thinking of transitioning out of providing the clinic as there are now other venues in the county that can and are providing primary care.  This has changed since the clinic was started a number of years ago.  Karen McCullloh  felt that closing the clinic should be done very carefully if at all since many citizens think that that is what a Health Department should do.  Much further discussion went on and there is much more research to be done to work into some of the more modern ideas such as the “Patient Centered Health Care Home” idea which is a very viable idea going on now.  The meeting adjourned at 5PM.

Submitted by Sue Cohen