Dear Editor,

As the Administrator of the Scotland County Health Department for the last 25 years and an employee for a total of 31 years I feel obligated to speak directly to the people of Scotland County regarding their health department services and the upcoming ballot issue. The one thing I hear most often is “I didn’t know you did that.” A lot of what the health department does is confidential. But some of the services we offer that people might know we offer is such things as blood draws, Blood pressure checks, blood sugar checks, cholesterol screenings, lead testing, toenail care, hemoglobin checks and Hemoglobin A1C screening along with Home Health Care and WIC. We can provide educational programs. In the past the people thought we only served the poor. This is not true, services are provided to anyone regardless of income.

Scotland County Health Department is a not-for-profit government entity established in 1979 after separating from Clark County. In April of 1980 a tax levy of 15 cents was put on the ballot and the people of Scotland County passed the levy to establish our own health department. We remain at that current level 39 years later. The health department currently has the lowest tax levy in the county.

The agency is led by a board of trustees elected within the county. There is a common assumption that employees of the health department are county or state employees, with county or state health insurance and retirement This is false. Employees pay scale is set by the board and no health insurance is offered. Only in the past 10 years has a retirement plan been started. Many people recognize the health department as visiting nurses that go to the home. This is our home health program. Although this program made money in the 1900’s and 2000’s it has since dropped 30% in reimbursement for a comparable number of visits, with a high level of care provided. Although home health is important as we address priorities within the public health agency, the priority must be those things mandated by state law. These things include (1) inspections of restaurants, daycares, convenience stores, grocery stores, school kitchens, temporary food stands, and lodging establishments (along with all complaints, follow-ups for these things, plus water and sewage) (2) Follow-up on any reportable communicable diseases like influenza, meningitis, pneumonia, E coli, and more (3) Follow up on any animal bites related to rabies vaccine and quarantine or testing of animals (4) Preparing for and responding to local, state and federal emergencies (Ebola, pandemic flu, tornados, earthquakes, anthrax, etc,) (5) Ensuring vaccine availability for uninsured and underinsured children and upholding state laws regarding vaccination and schools, as well as entering this information into the state system and ensuring safeguard of the vaccine (6) Having an administrator of public health on call 24/7 for all of the above issue’s and a nurse on call 24/7 for all home care clients.

The agency has chosen to provide a large amount of services that have partial funding associated with them, but that requires input of agency taxes or profits collected. The majority of trainings and meetings is supported by tax dollars. Walk-in clinics with free services and fee for service items- we have a nurse in clinic on scheduled days to provide free or fee-based services (blood draws, labs, injections, immunizations, etc.). They are meant to help those that can save money by paying cash through the agency, that can receive screenings they normally wouldn’t get or be able to afford, and for a variety of other reasons. Many ask us “why fees if we pay taxes?” The simple answer is that the additional things like lab have significant supply costs that are associated A needle for one blood draw costs $2.52. The other costs involved such as nurses time drawing the blood, preparing blood for pick up, paper work, contact with doctors’ offices, fax time, courier time, etc., cost of maintaining equipment Clinics cost a significant portion of the county tax payer’s dollars. We continue to do specialty services that have little or no reimbursement, STD testing and treatment, car seat installation and checks, skin screenings, etc. The health department was instrumental in writing the grant to start the Fitness Center and the Tiger Trail, also the grant that started placing a school nurse in the school. We continue to look for grants to benefit the health department and the community as a whole but they are getting harder to compete for. We are warned that more cuts are coming regarding state and federal funding. Without changes to our core, county mill tax income—we will have to revise the list of services we provide. I know there are people out there that think why did we get a new building? The board of trustees looked at what the building would cost and what we would be spending with an increase in our rent at the previous location and it only made sense for us to move and have actually saved money in other ways.

State statue allows the community to set the mill tax for the health departments at .40 per 100 valuation. We have been at .15 since 1980 the beginning of the Scotland County Health Department. We are asking for another 15 for a total of 30 cents. We truly hope you see the value of your local health department and continue to support it. If you have any questions feel free to give me a call.


Margaret Curry, Administrator