Health department prepares for future

Harrison County Health Administrator Anthony (Tony) Combs presented the health department’s annual report to the Harrison County Board of Commissioners Monday morning, June 1.
Per state regulations, Combs is required to compile the report each year.
The health department, split into five divisions, sees approximately 50 people a day in the office.
The Public Health Nursing Division ‘ which provides senior citizen screenings, home health visits, tuberculosis testing, communicable disease counseling, public health information, head lice treatment, colposcopy, biopsy, mammogram screening for at-risk populations and adult and child vaccinations ‘ typically administers 3,000 to 5,000 shots to adults and children per year. The nursing division stores approximately $200,000-worth of all types of vaccines at the facility.
‘Brittany Mercer, a public health nurse, left the department in October to pursue other opportunities, and Carrie Herthel returned to take her place,’ Combs said in the foreword of the report. ‘Carrie worked as a public health nurse for the department prior and returned because of her love for public health. She was able to hit the ground running due to her prior experience with the department.’
Combs said the division hosted regional meetings with other public health nurses to share information and best practices.
‘Senior sites were visited,’ he said. ‘TB screening and hepatitis B vaccines were given at numerous local businesses. Health fairs were attended, and school vision screening was provided to a local school that does not have a school nursing staff.’
The Environmental Division provides oversight of all private septic systems, including consultations for site selection and system design, contractor supervision during installation and final permitting. It works closely with the Indiana Dept. of Environmental Management and the Indiana Dept. of Natural Resources on trash and dump site clean up. Mold, lead and other health hazards are mitigated. Restaurants are inspected and graded on State Health Code; pools and public swimming facilities are inspected and monitored for bacteria. Animal bites are investigated, dead birds and other vectors are tested for diseases and mosquitoes are monitored and tested for West Nile virus. Annually, the Environmental Division issues more than 150 septic permits and periodically inspects the approximately 200 restaurants and food providers in the county.
‘Chris Cunningham left the department to become a stay-at-home dad for his two children, and Josh Purvis joined the staff,’ Combs said. ‘Josh brought plenty of experience to the division with his work with environmental issues in California. Mosquitoes were counted and typed, and soil tests were conducted in the lab. Restaurants were inspected to ensure food safety … ‘
The Vital Records Division records all births and deaths in the county. Birth and death certificates are provided to the public and other pertinent agencies. Statistics on causes of deaths are recorded and forwarded to other agencies. The Vital Records Division typically issues approximately 1,000 to 1,500 birth certificates and 1,500 to 2,000 death certificates per year.
Last year saw an all-time high for births in the county, with 439, up from 397 in 2013. There were 211 females born compared to 218 males.
Deaths were down from 314 in 2013 to 270 last year. Causes of death were:
‘Physicians cases ‘ age related, 6; Alzheimer’s Disease, 12; cancer, 59; cardiac-related, 31; cerebral-related, 8; dementia, 11; liver-related, 1; Inanition (exhausted condition resulting from lack of nourishment), 3; pneumonia, 19; pulmonary-related, 7; renal failure, 9; and respiratory-related, 8; sepsis, 7.
‘Other natural causes ‘ alcohol use disorder, 2; intra-abdominal hemorrhage, 1; Sudden Death Syndrome, 2; Lou Gehrig Disease, 1; Clostridium Difficile Colitis, 2; Human Immune Virus Encephalopathy, 2; Hemopericardium with Tamponade, 1; stroke, 2; bone marrow failure, 1; septic shock, 1; parkinsonism with dementia, 1; anemia, 1; intestinal calciphylaxis, 1; and traumatic asphyxia, 1.
‘Coroner cases ‘ vehicle accident, 2; drowning, 1; carbon monoxide poisoning, 1; asphyxiation, 1; multiple drug toxicity, 2; tractor accident, 1; fire, 1; gunshot suicide 3; carbon monoxide poisoning suicide, 1; age-related, 7; cancer, 2; cardiac-related, 30; cerebral-related, 1; diabetes, 2; pulmonary-related, 9; respiratory-related, 1; Alzheimer’s Disease, 1; pneumonia, 1; stroke, 1; and sepsis, 1.
All births and deaths in the county are statistically counted, regardless of where the person resides.
The Maternal & Child Health Division provides prenatal, family planning and women’s health care to under-insured or uninsured women. Some of the services provided include physical exams, blood work, vision, hearing and dental screenings, STD screening, pregnancy testing, PAP tests and breast exams. Approximately 500 clients are seen annually in more than 2,000 visits to the clinic.
‘Additional services were offered to both local clients and clients from surrounding counties,’ Combs said. ‘We were able to add another nurse practitioner to the staff to help with the expanded services. Kristi Tingle joined the staff in October with her experience and skills.’
Combs said luckily, so far, with the help of an aggressive and alert sheriff’s department, HIV has not been a problem in Harrison County as it is in nearby Scott County.
The Preparedness Division provides planning and response to health emergencies. It works closing with Emergency Management Agency, Emergency Medical Services, fire departments, law enforcement and other agencies to provide assistance in the event of any threat to the public’s health. Plans are in place to assess the situation and provide command and/or administrative assistance. If the situation warrants, four health department employees are trained to the level of HAZMAT Operations to assist with on-scene operations. Ultimately, a mass clinic can be set up to administer vaccine/medication ‘ similar to the annual drive-through flu shot clinic at Harrison County Hospital ‘to the entire population of the county in the event of a bioterrorism attack or naturally occurring outbreak.
‘As the administrator of the health department, I look back at all the changes of the past and look to the bright future ahead,’ Combs said. ‘We will continue to realize new and better ways of doing things and continue to look forward with anticipation to the challenges that are to come.’