Public health has had a makeover in Douglas County.
Immunizations, family planning and other programs formerly operated by the Douglas County Public Health Department are under new management, and members of the public were invited to a town hall to learn more Thursday.
The meeting was held in the Douglas County Health Department building on Madrone Street in Roseburg. The building was originally the old Mercy Hospital, and about 70 community members gathered in what was once the hospital chapel. They sat in orange chairs that looked like they’d been borrowed from a 1970s high school cafeteria.
They heard from Bob Dannenhoffer, recently appointed public health administrator by the county, that the services formerly provided by the county are still being offered — in many cases by the same people and sometimes at the same locations. It’s just the management that has changed, as the county has farmed out its programs to a collection of nonprofit organizations.
Oregon Public Health Director Lillian Shirley told the audience that Douglas is not the only county privatizing, or as she termed it, “modernizing” its public health services. Washington, Columbia and Curry counties are also making similar changes, she said. Shirley said it’s up to local communities to determine how they create the improved health outcomes that will meet state mandates.
Kathleen Johnson, of the Coalition of Local Health Officials, laid out Douglas County’s low rankings on health care measures like smoking and obesity, saying the county consistently ranks in about 30th place out of 34 Oregon counties ranked by the University of Wisconsin’s Population Health Institute.
Cindy Shirtcliff of Advantage Dental spoke about public health’s goals for improving those statistics. The former public health department helped create a Community Health Improvement Plan in 2014. The CHIP goals include creating “one-stop” shopping where low-income patients can receive multiple services, ensuring patients have transportation to appointments, creating free summer exercise activities and making more public places tobacco-free.
Some audience members suggested more data should be gathered and the community should be more involved in decisions about public health programs.
Diana Wales of Roseburg asked whether any data had been gathered to see if the programs already begun are meeting their objectives. Jean Galleher noted there seem to be no measurable timelines for reporting on the plan’s progress.
Shirtcliff said a report should be completed soon.
Several people expressed concern about transparency, saying they felt health decisions were being made out of the public eye.
Dannenhoffer heads the Douglas Public Health Network, which has contracted to manage public health services for the county. He said he wants public involvement.
“Douglas Public Health Network is trying to become really very open, that’s why we’re having this open meeting,” Dannenhoffer said.
Marcia Hall said the public needs to be involved in strategic planning, not just invited to attend meetings where information is presented.
“Personally I think there should be dialogue, and not meetings where we’re told what we can and can’t talk about,” Hall said. “We can have meeting after meeting and say whatever we want, but if it doesn’t really influence decision making it doesn’t really matter.”
Tim Freeman, the county commissioner who worked on the outsourcing of public health programs to private organizations, objected to claims that the county’s process wasn’t public enough.
“That has been a concern that has been brought up over and over,” Freeman said. However, he said the entire process has been filled with public meetings, right up until Thursday’s meeting.
“I appreciate a point of view that is different from the reality, but the reality is we tried very hard to have every bit of this as transparent and as public as possible, and we will continue to do so,” Freeman said.
Dick Dolgonas said health planning needs to be considered throughout the community, including all community leaders, not just medical providers.
“When you pave a road, there’s a health impact to how you pave the road,” Dolgonas said.
Dannenhoffer said one important need is increasing immunization rates. He said immunization clinics are open many more hours now than they were under the county’s health department. Another need is family planning. A majority of women on Medicaid want to go on birth control, he said, but most aren’t able to access it.
“There’s a gap between what women want and what women get,” he said.
After the town hall meeting, many people drove to the Umpqua Community Health Center, which held an open house for its new reproductive health clinic, where contraceptive and prenatal services will be provided.
You can reach Carisa Cegavske at 541-957-4213 or firstname.lastname@example.org.