The Joplin Globe, Joplin, MO

August 29, 2010

Jo Ellis: Health department duties spreading wider

By Jo Ellis
news@joplinglobe.com

CARTHAGE, Mo. — The parking lot at Central Avenue and Lincoln Street in Carthage has been a beehive of activity. That’s small wonder since the Jasper County Health Department is running three major programs from that location, serving roughly 117,000 county residents.

Tony Moehr has been administrator of the county health department the past seven years and an employee for almost 20 years, during a period when the county’s population has grown.

About a dozen professionals (including Moehr), plus clerical staff members, operate the health department’s three major divisions: the environmental program, the medical program and the lead poisoning prevention program. The department also provides vital records, birth and death certificates, for a fee.

The environmental program is responsible for the safety of food served in restaurants, hotels and motels, convenience stores and day care centers, and at festivals.

“We average over 500 food service inspections a year,” Moehr said. There are just under 300 food vendors in the county department’s jurisdiction. Those that serve a large volume of meals with more potentially hazardous foods are considered high priority, while others, such as convenience stores, are low priority.

Complaints about septic leakage and waste dumping are investigated. Wells and streams are tested for water quality. These are primarily private wells, Moehr said. The department has tested water in streams, around 600 samples annually, the past three years.

The duties of the five people in the environmental program also include issuing building and septic permits for new construction in the county. “Those guys stay busy all the time,” Moehr said.

In the medical program, three nurses and their clerical staff spend a lot of time on immunizations.

“These are primarily childhood immunizations, but also some adults,” Moehr said. “Last year, we gave 2,250 immunizations, plus 870 regular flu shots and 3,200 H1N1 shots.”

The medical clinic contracts with Dr. Debra Royce, of Sarcoxie, who comes in each Tuesday to see patients who qualify under a strict low-income requirement. The clinic has four examining rooms.

“We don’t see very many, but we have seen an increase since the Carthage Community Clinic closed,” Moehr said. “If it continues, it will be a major problem.

“We see more in our STD ( sexually transmitted disease) clinic. In conjunction with the Show Me Healthy Women program, we work under a state contract to give pelvic exams, Pap smears and mammograms to women who are underserved.”

The clinic does tuberculosis skin tests, a new requirement for employees of day care centers or anywhere young children are present. Around 450 TB tests were completed last year.

“Usually we have a couple of cases per year of active TB cases, which leads to a lot of testing and antibiotic therapy,” Moehr said. The six-month course is arduous, he said.

“People can be active or dormant,” he said. “They can test positive, but aren’t sick and can’t spread it, but they have to go on the medicine anyway. Last year, the clinic followed up on 190 patients who tested positive but weren’t sick.”

More than 300 pregnancy tests were conducted at the clinic in 2009.

The lead poisoning prevention program funded by the Environmental Protection Agency employs 3.5 people. Stemming from the 1990s, when a Superfund site was designated in Jasper County, the program works to identify and reduce lead sources, screens for poisoning, and educates children to clean their hands after playing in contaminated soil.

Jasper County passed an environmental contamination ordinance last year that requires anyone building a home close to a contaminated area to have a soil test done before the home can be occupied. Another EPA contract funds this service.

About 40 percent of revenue for the budget comes from county general revenue funds, permit fees and adult immunization fees. About 10 percent is provided by state funds, and the remainder comes from federal contracts.