Health agencies prepare for worst

? A modest brick building next to City Hall receives steady traffic on a weekday as patients come in for shots, checkups or other basic health services.

The Reno County Health Department and its staff of 51 would be part of Kansas’ first line of defense against any bioterrorist attack. Yet officials here and across the state believe the public health system is underfunded, understaffed and overworked.

Health officials are grappling with preparations for any major outbreak of disease whether terrorist-related or not and working to improve communications with other emergency management departments while continuing to provide basic health services to the community.

Creating a plan

Kansas’ 99 local health departments, each serving one county or a region, are trying to develop contingency plans, educate and train employees to handle possible outbreaks and put more emphasis on investigating diseases.

“These are all good ideas, but they take money, time and people, which are in short supply,” said Judy Seltzer, director of the Reno County department.

Many legislators agree the departments play a vital role in domestic security but doubt that the agencies will see any new funding.

State grants to local health departments in the current fiscal year totaled $2.2 million, with some receiving just $7,000. They rely heavily on local property taxes and billing clients.

Public health advocates would like to see the state increase its spending by $1.25 million. That’s not much money for the state, but a lot to ask when Kansas government faces a $700 million budget shortfall.

“Public health is the essence of homeland security,” said House Minority Leader Jim Garner, D-Coffeyville. “But given the current economic environment, it’s tough.”

‘Front line’ in attack

To prepare for disease outbreaks and emergencies, the local departments work closely with the Kansas Department of Health and Environment and the federal Centers for Disease Control. They also exchange information about illness and diseases within their communities.

However, if an event occurred, a county health department would be expected to manage the outbreak for up to two days before outside help would arrive.

“We’re overwhelmed and overworked, but we’re doing our best,” said Allison Weingartner, spokeswoman for the Shawnee County Health Department. “The county health departments are really going to be the front line in the event of a bioterrorist attack.”

Some officials worry that the multiple demands are being addressed at the expense of some programs.

“The public health plate covering all sectors of the health care system and financial levels being as tight as they are, we don’t have a lot of staff that’s not already busy,” Seltzer said.

“So putting together a bioterrorism emergency plan, which takes meetings, research and training, is something we’re doing on top of everything else,” she said. “In reality, something is getting squeezed and left out.”

Realistic expectations

The federal government has promised nearly $1 billion for health departments nationwide, and county agencies are waiting for that money to funnel down to help with the cost of bioterrorism preparations.

But Sally Finney, lobbyist for the Kansas Public Health Assn., said those funds will be earmarked for specific uses and won’t be available for continuing needs.

“The fact is, we’re under threat every day,” she said. “The truth is that there’ll be another pandemic.”

State Sen. Jim Barnett, a physician with a private practice, said the Legislature must be realistic about what it expects from the agencies.

“We have relied more and more on county health departments to provide services,” said Barnett, R-Emporia. “We can’t expect them to do things if we can’t provide the resources.”

The local agencies are pushing ahead to prepare for bioterrorism, believing the work will improve their readiness to handle outbreaks and other problems.

“It’s not good having to prepare for terrorism, but of out that we will have a stronger public health system that will help fight disease in the future,” Seltzer said. “It is not a battle that is ever over.”