While many tend to associate the Marion County Health Department only with COVID-19 vaccinations and testing, the department does far more than deal with the recent pandemic.
“Our relationships with the public and other agencies have really been strengthened as a result of the pandemic so we are seeing positives come out of it. It has brought public health to the center stage,” said Marion County Health Director Krista Schneider. “But we also do more than just COVID-19.”
The health department focuses on public health and all that falls under it.
The CDC Foundation describes public health as the science of protecting and improving the health of people and their communities. This is achieved by promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing and responding to infectious diseases. Overall, public health is concerned with protecting the health of entire populations.
Schneider and her staff try to prevent problems from happening or recurring by implementing educational programs, recommending policies, administering services and conducting research – in contrast to clinical professionals like doctors and nurses, who focus primarily on treating individuals after they become sick or injured. Public health also works to limit health disparities. A large part of public health is promoting healthcare equity, quality and accessibility.
“We have a WIC program. A lot of times people are unaware of who qualifies for WIC and many qualify such as pregnant women, breastfeeding women up to their baby’s first birthday, non-breastfeeding mothers up to six months after their baby’s birth, infant and children up to five years old. All qualify as long as they fall within the income guidelines. If someone is already getting food stamps or on Medicaid already, they will automatically qualify for WIC,” said
In addition to breastfeeding support and classes from Breastfeeding Peer Counselor Lynette Hiebert and International Board-Certified Lactation Consultant Charla Duerksen, WIC provides participants with healthy foods, nutrition education and referrals to other available services. For the Kansas WIC Program Income Eligibility Chart to see if you qualify, go to https://www.kdhe.ks.gov/DocumentCenter/View/9150/Income-Guidelines-PDF?bidId=.
There are many other services offered as well including hearing and vision screenings for children in Marion County schools, immunization clinics and events, Marion County school safety inspections, educational classes and more. There is also a whole program devoted to keeping kids safe which will be featured in an article next week in the Free Press.
A large part of the work that the county does is immunization and epidemiology which conducts reportable disease investigation.
“We help prevent the occurrence and spread of disease by investigating cases that are reported to us by our local healthcare providers and KDHE. With this collaboration we are able to prevent and target the cause of disease outbreaks and then determine the best response for the members of our community and keep them safe,” said Immunization and Epidemiology Nurse Pam Holub.
Schneider reports that there has been a decrease in immunizations since the pandemic occurred. She said that sustained poliovirus transmission had been eliminated from the US for more than 40 years with the last US case of polio caused by wild poliovirus occurring in 1979. The Who Region of the Americas was officially declared polio-free in 1994.
But in June 2022, the poliovirus was confirmed in an unvaccinated immunocompetent adult resident of Rockland County, New York. This was the second identification of community transmission of poliovirus in the US since 1979.
Epidemiologic investigation revealed that an unvaccinated adult attended a large gathering eight days before symptom onset and they had not traveled internationally during the exposure period. Local officials began monitoring wastewater after the first case and found the poliovirus detected in 100 wastewater samples, 93 of which are genetically linked to Rockland County polio. The last positive sample was taken on Dec. 16 in Orange County, New York.
“Immunizations are important for keeping disease down,” said Schneider.
In addition to the services they already offer, there are a few programs that Schneider and her staff hope to initiate and implement in the near future depending on space and funding. For much of their funding they apply for grants so the cost doesn’t fall on Marion County taxpayers so heavily.
“We are hoping to start the Chronic Disease Risk Reduction (CDRR). The mission of the CDRR community grant program is to address chronic disease risk reduction through evidence-based strategies that impact commercial tobacco use, physical activity, nutrition and community resiliency while addressing health equity,” said Schneider.
She said that chronic diseases account for 90 percent of healthcare costs each year. As states struggle to meet the staggering costs of health care, the most cost-effective interventions are frequently overlooked. Impressive achievements in population health are possible by reducing the prevalence of risk factors that underlie chronic disease.
An important piece the department would like to build in is family planning.
Schneider said, “The Kansas Title X Family Planning (FP) Program provides individuals the information and means to exercise personal choice in determining the number and spacing of their children and provides access to additional health services that lead to the overall improvement in the health of those individuals while prioritizing services to low-income and high-risk individuals.”
Sexually Transmitted Infection (STI) and HIV Testing is another area that they hope to provide more services for.
“The Sexually Transmitted Infections (STI)/Human Immunodeficiency Virus (HIV) Program works to stop the spread of STIs and HIV in Kansas. It provides testing through blood draws and urine samples that are then sent to the Kansas Health and Environment Laboratory free of charge. Right now people in Marion County have to go to McPherson or other counties to get tested because we don’t offer that service.”
Any expansion will be dependent on office space and other needs. The health department is currently housed in Marion in a building owned by St. Luke’s Hospital and Living Center and they need two of the offices back for their own use. While the health department has a great relationship with the hospital and has enjoyed the arrangement for years, there are many needs that cause them to need a bigger space that is better equipped for more services. They are hoping to find or build a space that has 5,300 square feet including a garage to store items in a climate-controlled area, a reception desk that faces the front door, a lab, a covered drive-thru for pandemic testing, space to hold classes and more.
For example, adding the Family Planning/STI programs will present the need for two exam rooms. “Currently we provide immunizations on Monday, Wednesday and Friday and WIC services on Tuesday and Thursday. Each service uses the exam room. With the addition of another exam room, we would be able to provide some concurrent services,” said Schneider.
They are in need of a separate lab area due to infection control risks.
“We currently use the counter in the vaccination room for COVID-19 testing. Clean and dirty should not be housed in the same area without definitive separation. We will need a locked medication room to meet pharmacy requirements for the Family Planning program. We also need a closed area to store biohazardous waste (dirty utility room),” said Schneider.
The COVID-19 pandemic presented a need for a covered drive-thru area for COVID-19 testing and immunizations done for clients that have difficulty ambulating. Those services have been provided car-side. A covered drive-thru with a properly designed building would protect patients and staff from the weather elements and eliminate the safety risks of taking biohazardous waste and soiled PPE into a waiting area and down the hall.
Schneider pointed out that outdoor testing was needed with H1N1 several years ago as well as COVID-19 and it will be needed for future pandemics down the road because there will be more pandemics.
“There will be another pandemic at some point in time and we want to make sure our community is adequately prepared,” said Schneider.