ROBERT PIERCE

   • Leader & Times

In late April, county commissioners met with Seward County Health Department Director Brie Greeson regarding issues with the health department.

The meeting was not livestreamed, and the Leader & Times later spoke with Greeson about the meeting. She said the work session came about after prior commissioners had asked for an update on the health department.

“I thought it would be very beneficial for the new commissioners who came on after the first of the year to have a little overview,” she said.

Greeson said among the issues discussed was the commission’s role as the county’s health board, vaccines and the impact schedule changes and community access considerations would have on vaccines in the county.

“We went over our hours of operation with community needs, staff capacity and talked to them about why that schedule had apparently gotten that way prior to me coming here,” she said. “We talked about funding streams and our grant overviews.”

With grant money allegedly being used for bonuses for staff, Greeson said funding sources, the current challenges with sustaining funding, SCHD’s active grants, funding requirements and restrictions and strategic use of those funds were discussed.

“We talked about staffing and cross training, the current staffing structure we had, us assisting at the jail, what cross training efforts are happening and our workforce stability and what openings we have,” she said. “We talked about doctor days, the current model, the opportunity for expansion and potential retirements upcoming and how we’ll structure those, operations overview. We covered most of that in the prior discussion, so I didn’t say much there.”

Part of the discussion, Greeson said, also included current compensation structure, comparison and competitiveness with other medical places in and around Liberal, what retention and recruitment efforts, what the federal poverty level is showing and how she is trying to align county priorities with budget restructuring.

“Then we went into open questions and comments,” she said. “We did talk about potentially growing our own LPNs and potentially having one of the nurses stay part time for a short time.”

Greeson said  Kansas statute dictates that the county commission serves as the health board for the county.

“KSA 19-212 is to contract for protection and promotion of public health and welfare,” she said. “There’s some other stuff in there about their responsibilities as the board of health, and they support the health officer.”

As the county’s biggest provider for vaccines for children, Greeson said SCHD is in good shape at this time with its vaccine supply. She added with restrictions and the health department’s fiscal responsibility with the county, vaccines are remaining scheduled to allow staff what clients need when they come in and to make sure supply is on hand.

“We are also going to do a walk-in vaccine clinic July 20 through 23,” she said.

At this time, Greeson said SCHD is down some nursing positions, and she said she will not rehire for the clinic clerk position or a nursing position left with former Vaccine Coordinator Alexa Varnes.

“We’re not refilling the Life Care labs position,” Greeson said. “That was Alexa. The staff’s cross training to cover that.”

SCHD is open 8 a.m. to 5:30 p.m. Monday through Thursday, and Greeson said staff from the upstairs and downstairs portions of the health department comes in for doctor days, family planning and maternal and children’s health needs on Fridays.

Greeson said the health department’s current schedule was put in place under the direction of former Director Martha Brown.

“From what I’ve been told, it was because of financial things with the county so they could not have us here a day for fewer hours and also, we had a lot of cancellations and not very many patients who came in on Fridays,” Greeson said. “Unless the commission votes to change it, that’s going to be the hours we’re using.”

Concerns have also been raised about the use of Public Health Incentive Grant (PHIG) money the county has received. Greeson said everything the health department did prior was done so in accordance with grants and approved by the commission.

“With our funding for this year, they’re working with me on how they’re realigning those funds,” she said. “We’ve got a couple of things in the fire right now. What I’m trying to do with the PHIG funding is to do something with that’s going to sustain the health department for a couple years. It’s going to be potentially paying for our electronic health records for a couple more years and also keeping some of our equipment.”

Greeson said she is working to cross train much of SCHD’s staff.

“When I first started here, all of the staff was pretty much just pigeon holed into their specific areas,” she said.

Greeson said use of the health department’s Women Infants and Children (WIC) staff for other needs is minimal due to grant requirements, and this led to the need to cross train other staff to help meet client needs.

“The staff who’s able to be cross trained, I’m trying to have them cross trained to other areas of the health department so we very rarely have a day when we can’t do a service because we don’t have somebody who’s here to do it,” she said.

By cross training staff, Greeson said this allows the entire health department to be open every day staff is working.

“If somebody comes in for a pregnancy test and somebody’s gone, they can still get that somewhere in the health department, or if they need vaccine, we’re getting that to them somehow,” she said. “My goal is we should very rarely ever have to say, ‘I’m sorry. We can’t do that today.’”

Greeson has been director of SCHD for five years, and in that time, only once has a service been denied due to lack of staff. She said this is because all workers had gotten sick, and she said giving clients the ability to come through the door and get services, through cross training will make this possible.

“It’s more fiscally responsible, and you’re able to offer those services to them whenever they need if we’ve got the staff cross trained for it,” she said.

As far as doctor days, Greeson said a nurse practitioner comes to the health department to see clients in various programs.

“We don’t have an actual doctor here who comes and sees patients for sick visits,” she said. “It is for the nurse practitioner to come in and see the patients in family planning for their pap smears, their breast exams, their well woman checks and IUD (Intrauterine Device) implant or for our program in MCH for them to come in and see the nurse practitioner with the pregnancy care and whatever they’re needing with that when they’re in that program.”