Why is Georgia Public Health in Crisis?

While this article does point out “some” of the problems with public health in Georgia the main issue is NOT reported.

The main issue is this state has never adequately funded public health programs and ranks at the middle to last compared to most states in funding and at the bottom for health outcomes.

The politicians of both parties and the citizens of this state have said for years that public health is not something that is very important (just like education, etc.). This is very evident if you just look at where we fall health-wise compared to other states. Go to the Kiaser Family website (Link) and compare Georgia to other states health rankings. We have ranked in the bottom of almost everything related to health measures forever.

The committee looking at this is going to “study” and “find” a solution that already has been decided. Their solution is to combine Public Health with the Department of Community Health and create a Department of Health. No more money, just going to shuffle the cards again.

Kinda like how we have address the issue of kids dying in custody of DFCS by hiring a new head every year, firing them when an overworked case manager misses something and a kid dies. DFCS did that for years and never really addressed the issue of low pay, high turnover, high case loads, and poorly trained staff.

Every time a kid died DFCS would pay some consultant a lot of money to once again “study” and “find” a solution to the problems caused by lack of adequate funding – and DFCS always ignored the money part and focused on other issues. Suddenly when they were found guilty in a federal lawsuit did the politicians find the money to train and hire adequate staff that dozens of consultants had suggested.

So, instead of focusing on the lack of funding and instead focusing on the the new (again) “crisis” they are going shuffle the chairs of the Titanic and fold Public Health into the Department of Community Health. You know, the folks that are going to start throwing those middle/low income kids off of PeachCare.

Yeah, this is going to work out fine……

Georgia public health ‘in crisis’

The Atlanta Journal-Constitution
03/02/07

Georgia’s public health system is in a state of “crisis,” burdened by inadequate funding and a shrinking pool of nurses amid rising demands for services, a legislative committee has concluded.

If a pandemic or other major emergency occurs, the panel said, “the medical system in Georgia will collapse” unless improvements are made to public health.

The recommendations of the study committee’s five members — all Republicans — include revising how funds are allocated and creating a new Department of Health, combining the state Medicaid agency with the health functions of the Department of Human Resources. House Bill 514, recently introduced in the Legislature, would set up a commission to consider such a restructuring.

The public health nursing force — the poorly paid backbone of the state’s system — has dropped to 1,556 in 2006 from 1,700 in 1990, according to the report from the House Study Committee on Public Health, which held hearings in December. The state’s population has risen dramatically in that time.

“Public health nurses are not paid competitively, have little room for advancement, and are being overloaded with extra responsibilities, such as tuberculosis interventions and bioterrorism planning,” the report said. “In the event of an emergency incident, the effects of the shortage will be magnified tremendously.”

Salaries for Georgia’s public health staff nurses average $36,753 — 40 percent lower than the $61,206 average for the private nurses in the state.

The panel says the state should make nurses’ pay competitive, provide opportunities for advancement and offer tuition reimbursement for nursing students.

“Our health departments are doing a great job with the resources they have,” Rep. Donna Sheldon (R-Dacula), the committee chairwoman, said Thursday. But she added, “We have to do better with funding our health departments. We need to increase the resources to make sure we’re prepared in the future.”

Other panel members are Reps. Ed Rynders (R-Albany), Ron Stephens (R-Garden City), Len Walker (R-Loganville) and Mickey Channell (R-Greensboro).

Rural counties have an advantage under the existing funding formula, the committee concluded.

Tiny Taliaferro County, for instance, receives $39.12 per resident, the highest per capita allocation in the state, compared to Forsyth County, with the lowest at $2.17.

The nursing shortage is worse in public health than other areas of health care, said Linda Easterly, president of the Georgia Nurses Association.

“When we do have a pandemic, public health nurses are our first responders — setting up shelters, helping to triage, and directing the plans of the state,” she said.

Pat Brannen, public health nursing and clinical coordinator for the state’s Southeast Health District, said nurses can sometimes make twice as much in the private sector as in public health.

“Because of that, no matter how committed our public health nurses are, some of them just cannot afford to stay,” she said. Low salaries and heavy responsibility can also make hiring difficult, Brannen said. She said it took her two years to fill a nursing job in one rural county.

Brannen, whose district covers 16 South Georgia counties, said public health nurses can cut medical costs and even help the economy of a community.

In Evans County, she said, a public health nurse cared for a malnourished pregnant woman who was living in a car. Her baby was carried to term and delivered healthy.

The savings of keeping the baby out of a neonatal intensive care unit would have paid the salary of more than one nurse, Brannen said.

The state Division of Public Health, currently part of the Department of Human Resources, works with local boards of health to offer a range of services to residents, from inspecting restaurants to controlling disease and providing immunizations.

Responses to pandemic flu, terrorism, natural disasters and mass casualty events are also public health’s responsibility.

Among other findings:

• Public health budgets are being squeezed as inflation and population growth have outpaced spending.

• Georgia ranks sixth nationally in incidence of tuberculosis, partly due to the influx of immigrants and “deteriorating public health infrastructure.”

• The switch of hundreds of thousands of Medicaid patients to HMOs has drained revenue from public health departments.

Stuart Brown, director of the Division of Public Health, said he is “delighted that the policymakers here in Georgia are beginning to face some of the issues that challenge us in public health.”

The nursing shortage, he said, is “very real … up until now, we’ve been saying we need to tweak the system somehow. But it’s becoming apparent that it’s going to take more than tweaking the existing system.”