ENTERPRISE — With COVID-19 on the doorstep of Wallowa County, it’s become evident that the Oregon Health Authority is Wallowa County’s de facto public health department, with no local department of public health.
But despite rising local concern over the availability of hometown-based public health services, those services, including reproductive health, Early Headstart and vaccinations are still provided locally and are easier to find than it might seem.
In early July, the OHA designated yet another public health service to a local clinic. Winding Waters Community Health Center became the COVID-19 case tracker for Wallowa County.
“We support the OHA with COVID-19 case investigation, contact tracing and follow-up phone calls to see how people are doing, as well as wrap-around supports to provide people with things they need to maintain their quarantine,” Winding Waters’ CEO Nic Powers said. “We also recommend that if patients have medical questions, they contact their primary care provider. We want people to work with their own providers.”
The Wallowa County Commissioners voted unanimously in April 2018 to transfer its local public health authority to the Oregon Health Authority, based on lack of funding. The OHA assumed the role of public health department after the county’s public health budget declined, reducing public health staff to one part-time staffer, according to Commissioner Susan Roberts.
“We didn’t lose public health capacity. We relinquished it,” Roberts said. “The OHA made the county commissioners the local health authorities, just as we are also the mental health authority. We contract the mental health services to the Center for Wellness. But we did not have a one-stop entity in Wallowa County that could take on all the functions of public health.”
So, after meeting with local providers, in October 2018 the OHA designated local organizations to be public health agency providers in the county — Building Healthy Families for the car seats and other programs, both Winding Waters Community Health Center and Mountain View Medical Group for required immunizations and vaccinations and Winding Waters for pregnancy and reproductive health services.
Wallowa County’s public health department just sort of faded away, Roberts said.
“The Oregon Health Authority determines which portions of public health your county is eligible for, and that depends upon your population,” she said. “When I first started, there were 16 elements of public health that we were receiving money for. They required that you had a minimum number of cases in each category, and they funded those elements. And over time, the money they were sending kept diminishing; yet the demand for what our staff did increased. The state was not providing enough funding to pay for two full-time staff people.”
Eventually, as funding shrank and administrative paperwork grew, the county’s full-time public health registered nurse left, leaving only a part-time employee to run the program.
“The state would come in … and they’d spend two or three days here writing up a whole list of things you were doing wrong,” Roberts said. “It was time consuming, frustrating and became so onerous that our public health nurse took a different job.”
In April 2018, the commissioners voted unanimously to relinquish the functions of public health to the OHA. In the following meetings, OHA, the commission and local providers made agreements on which local medical and care providers would pick up the local services.
“When Winding Waters moved some services into what had been the health department offices in Enterprise,” Powers said, “we also took on the health department phone number. Today, if you dial that old phone number, you’ll get Winding Waters.”
Building Healthy Families, which was already providing family, infant and child care education is now the provider for Early Childhood Education Headstart, although the program is administered through Umatilla and Morrow County. Classes are conducted here in Wallowa County, and Building Healthy families would be happy to help any eligible families here enroll, said Annie Mildrexler, who is the BHF certified car seat installation specialist.
Other portions of public health, including providing and installing infant and child caar seats on a sliding expense scale, providing safety (bike) helmets for children, and a program to help people reduce or eliminate their use of tobacco are also now offered through BHF. “We can even help you install a child car seat if it’s yours, Mildrexler said. “And we sell infant car seats of the right size at cost because there’s no place locally to buy them.”
The other programs that were never based here remained with the original providers. Those included environmental health (pool, lodging and restaurant) inspections, lead and pesticide poisonings and drinking water quality.
“The state has always funded the environmental health inspector,” Roberts said. “He works out of the Grant County Public Health Office, but he’s over here all the time. He came over to provide a permit for the food carts at this year’s Fourth of July fireworks.”
The only public health service that Wallowa County itself retained was keeping vital records — birth, death and marriage certificates. Those records are now maintained in the Wallowa County Clerk’s office.
“It’s just a lot faster and more efficient if we keep those here,” Roberts said.
Will Wallowa County reinstate its public health department anytime soon?
“We don’t have the population here to make it feasible for Wallowa County to maintain its own public health department,” Roberts said. “Now, the local people who are equipped to do that sort of thing are doing it.”