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Code blue at the Health Department
County services cut back in wake of state funding difficulties
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ERICA GREEN just wanted to help. A senior at Beach High School, she was a teen peer counselor for the Chatham County Health Department’s Adolescent Health and Youth Development Program.

The peer counselors went to local churches and high schools to talk to other teens about health issues, including sexuality and protection against sexually transmitted diseases.

“We would have training twice a week and we would go into the community numerous times throughout the month,” Green says.

The voluntary position required a lot of work. ”We were always preparing ourselves, learning as much as we could, to be knowledgeable,” Green says.

Teens are much more likely to talk to other teens than adults, Green says. When they have questions about sexuality, they don’t always get the best information from their friends.

“That was another reason we trained so often,” Green says. “Teenagers get information that isn’t always correct and isn’t always from a reliable source. We were accurate. Our peers could come and talk to us and get the right information. If we didn’t know something, we’d go back and ask.”

All that ended in June when funding for the program vanished. Green says when she and the other counselors were told, they were upset. “A lot of people in the program said it helped them as much as it helped the ones they were helping,” she says.

“I think it was a great loss that was unexpected,” Green says. “Hopefully, something good can come from this so that teens will have someone to turn to. It seemed to me that this was something very important that needed to be done. It was something I wanted to be a part of.”

ZaDonna M. Slay, Program and Evaluation Manager with the Chatham-Savannah Youth Futures Authority, echoes Green’s concerns. “Young people won’t have that professional safe haven now,” she says. “They will only have their friends or someone they may see as a big brother or sister, who may not have correct information.”

The Chatham County Health Department has the most valid information about health issues, Slay says. “There are so many young ladies who don’t know about the HPV virus,” she says. “The health department provides public awareness and advocacy.”

Some of Slay’s friends were teen peer counselors when they were in high school. “Peer counselors keep everything confidential,” Slay says. “A lot of teens said they considered it a job. They took it very seriously.”

Teens may worry about sexually transmitted diseases, teen pregnancy and other issues that they aren’t willing to take to adults. “From the young people I work with now, I see the common theme is, ‘We don’t have anywhere to go’,” Slay says. “They don’t have a place where they can seek information and guidance.

“A program such as teen peer counseling helped provide that for them,” she says. “I really hope that even with the budget cuts, some entity will take it on, even if it’s on a smaller scale, so peer education will still exist.”

The teen peer counseling program isn’t the only one affected. The health department is facing budget cuts of almost $1 million, a whopping 10.5 percent of its total budget.

The decrease in revenue is a direct result of budget cuts at the state level and has already begun impacting programs at the health department, whose current fiscal year began in July and will continue through June. “These cutbacks are hitting us hard,” says Dr. Diane Weems, the Chatham County Health Department’s Chief Medical Officer. “We provide necessary services for the citizens of Chatham County, many of whom have limited means to health care access.”

In addition to programs, some jobs are being lost. Two employees were terminated and eight open positions will not be filled.

Also lost was support funding for programs such as character education, nutrition and physical activity outreach. Reductions have been made in the Women, Infant, Children (WIC) program, which provides nutrition education and supplemental foods to low income families.

All after-hours clinics are gone. Employees have been told there will be no salary increases this year, and furloughs for all clinical nurse practitioners have been eliminated.

However, the cuts haven’t slowed demand. So far this year, the health department has provided more than 74,000 clinical services to 40,043 patients. It operates the third largest HIV/AIDS comprehensive care center in the state.

Many people know about the health department’s minination program, especially flu shots. This year, 31,270 immunizations were provided, although the successful drive-through flu-shot clinic conducted the last two years had to be discontinued because of the cuts.

In addition to providing health services, the department inspected more than 1,400 restaurants throughout Chatham County in 2008. The health department also is in charge of public records, and this year provided birth and death certificates to 18,270 clients

Weems says the budget cuts are “unusually severe, there’s no question about that.”

“The hardest part with those cuts is that a lot of those were positions for support staff,” Weems says. “The impact of that is we are losing support staff at a time when we are seeing increased demand for some core services, such as WIC, immunizations, family planning and child health. We actually have fewer staff, including nursing hours, to provide those services.”

When taking a furlough, the clinical nurse practitioners worked in the community, dealing with women’s health and family planning. “Now 24 hours a month in family care is lost,” Weems says. “Somewhere between 25 to 45 patients have less capacity to see someone. It doesn’t sound like huge number, but cumulatively, it is a lot.”

Could the situation get even worse? Yes. “That’s the message we’re getting from the state,” Weems says.

For now, the health department staff is coping by working more efficiently. “Everyone is still working 40 hours a week and we’re always asking them to work more efficiently and effectively. But we’ve reached the point where we’ve maximized that,” Weems says.

“I credit the staff with stepping up to the plate,” she says. “But if we have added budget cuts, we may be looking at more drastic measures.”

Health department funding comes from the Georgia Department of Family and Children Services. “When the legislature convenes after the first of the year, we’re hopeful they will look at approaches that make sense and offset some of these cuts,” Weems says. “When the economy takes a downturn like this, there tends to be an increase in demand. That’s the hard part.”

The cuts weren’t entirely unexpected. “A travel freeze had been put in place several months ago,” Weems says. “We knew there would be no salary increases for the staff. Even so, the budget reductions we’ve seen have been much deeper than anticipated.”

State funding provides about 40 percent of the health department’s total budget. “The rest is a mix of money from the county, fees generated by services, Medicaid fees, federal aid and grants,” Weems says.

“One key message is we certainly don’t want this news to deter families from seeking services they need,” she says.

“We realize that with all the job losses, families who have never accessed Peach Care may need those services. They should seek the services they need to maintain their health.” cs