Since 2008 local health departments have lost about 25% of their staff due to budget cuts that still have not been restored. As painful as those cuts were, what has been particularly troubling is how ill prepared our system was to address the pandemic and beyond.
Many public health professionals have opted for early retirement, others have become so disenchanted with the mess that they have left for greener pastures.
“I just can’t keep nurses from leaving for better opportunities”, said an administrator with 25 years of experience. “They see the lack of funding, the staff being overworked from lack of employees to share the load. Some are so tired, they just can’t take it anymore.”
Another director shared that his agency is at risk of being permanently shut down. A conversation with one of his county commissioners, confirms it. “I want to do away with the health department”, he said.
While these types of comments were common in my working with local health department leaders, I have never seen such an avalanche of despair.
Yet, there are other health departments that have managed to hold their own through 2020. The Montgomery County Health Department in North Carolina which serves a rural population of approximately 30,000 actually saw pretty good numbers as of October 2020.
This after conducting hundreds of drive-through Covid tests per week
“Overall clinic visits at this time last year saw about 200. Now we are around 138. At the beginning of the pandemic we were around 60, so it’s coming back”, said Mary Perez Administrator. “In the beginning of the pandemic, we were only scheduling about 10 per day. Normally, we would see 20-25. Yesterday we had 18, so it is coming back.”
Mary shared that in October she lost all of her clerical staff and was looking for new hires.
I speak with and coach a lot of public health leaders every month. Few have the positive attitude and ability to face obstacles like Mary Perez. When asked during our monthly coaching call how she has retained her core staff and remained functional through 2020 she responded, “Well, we’re going to continue moving forward. That’s what I keep telling the staff. We move forward despite everything. If we can’t get around the obstacle, we’ll jump over it. We’ve just got to keep moving. We’re not going to be defeated.”
Mary has invested in HDM’s monthly marketing and training to help her agency not just survive, but thrive. To increase awareness and visits, before the pandemic she implemented partnerships with local businesses to offer incentives for the public to come in for immunizations and other clinical services. She has been open minded to fresh ideas and expects positive outcomes.
Like all challenges in life this one has a silver lining:
For 20 years I have written and lectured on the loss of awareness the public has in the local health departments. As the years have rolled on, public health became more invisible and almost irrelevant. Like 9/11, H1N1, bird flu and natural disasters, Covid-19 has brought public health an audience we haven’t seen in years.
Mary Perez is using every tool at her disposal (and there are many) to help her agency reach, educate and serve more people than ever before.
Bravo Mary!