Public health leaders in Douglas County have been scrambling for the past years to find the best way to deliver services as timber revenues dried up, followed by federal offset payments.
Some services have been decentralized and spun off to non-profit organizations. Now a new consortium of non-governmental organizations -- the Douglas Public Health Network -- hopes to contract with the Roseburg-based county to provide some of the remaining services, including community-wide examinations of communicable diseases and epidemiology.
The nonprofit network, incorporated with the Secretary of State this year and headed up by Dr. Bob Dannenhoffer, is set up as a coalition of both for-profit businesses and non-profit groups with a long history of serving the county.
“Some services can be provided more efficiently through our community organizations,” Dannenhoffer told The Lund Report. “There’s a considerable of sense of community down here, which we saw the strength of recently.”
The Women, Infants and Children Program, which typically deploys federal funds for nutrition to county governments, has already been handed over to the Umpqua Community Action Network, which has long run a food bank and hooked low-income residents up with energy and heating assistance.
The authority for county mental health services have been turned over to the non-profit Community Health Alliance.
If changes in federal timber policy have decimated Douglas County’s budget, Dannenhoffer said the Affordable Care Act has relieved the county of much of its responsibility to provide safety-net public health services, since far fewer people are without health insurance, and preventive and reproductive healthcare needs are required to be covered for free for both those with Medicaid and private coverage.
Dannenhoffer, a pediatrician, is working with the Umpqua Community Health Center, which plans to take over immunizations, venereal disease screenings and women’s reproductive health services. Patients at the health center have always been able to get these services through Umpqua, but come Nov. 9, the center will open its doors to everyone for public health needs.
Both the action network and health center are located at a non-profit campus on the north edge of Roseburg, but the health center also has satellite locations in Myrtle Creek, Glide and Sutherlin -- an important benefit in a Southern Oregon county that spans an area the size of Connecticut.
Douglas County had satellite public health offices in Canyonville and Drain -- 30 miles south and north of Roseburg, the county seat -- but had to retrench all services to Roseburg because of budget cuts.
“They´re actually are going to become more available,” Dannenhoffer said. The satellites are not always staffed with the necessary providers to do all the services, but he hoped that reproductive health services and screenings could be done at those locations once a week and immunizations daily. Neither the satellites nor the Roseburg clinic offer weekend service.
Services for coastal Douglas County will be delivered by the Lower Umpqua Hospital in Reedsport.
He believed putting providers in the lead for venereal disease screening and prevention will improve the county’s chances to keep disease rates low, with more ability to reach out to the people most likely to be sexually active with multiple partners.
“The people most likely not to have a provider are young adults,” he said. “We hope this is a way to bring them in.”
Dannenhoffer said the county agency would remain the public health authority for Douglas County, but the public health network may be more nimble at heading off an epidemic, so ẗhat the Health Department is not the last to find out about an epidemic.
He said the budget, staffing levels and scope for the Douglas Public Health Network still need to be worked out with the county government, but he envisioned public health officials in regular communication with the county’s healthcare providers to share information about unusual disease developments among their patients.
Rep. Mitch Greenlick, D-Portland, who headed a recent task force that sought to modernize the state’s public health system, said it was the first he had heard of the Douglas County initiatives, but they sounded promising.
“It looks like it fits the model,” Greenlick said. “They need to make sure that people are getting the services.”
Greenlick said that he expected the Oregon Health Authority to submit a county-by-county plan on public health delivery during the 2017 legislative session. He planned to call Director Lynne Saxton before his committee meets in December to discuss the agency’s progress.
Cash-strapped Douglas County isn’t alone in moving away from a public health role for the delivery of healthcare -- Washington County, the state’s wealthiest, has also closed its more expansive safety-net clinics, arguing that the Affordable Care Act has made them duplicative and less necessary, while their closure should free up capital for an increased epidemiology staff and more promotional campaigns for public health awareness.
