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Only on 9: Jones County Health Department failed 31 state benchmarks

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TRENTON, N.C. -

A local health department is working to bring itself up to state standards. The Jones County Health Department failed 31 out of 148 benchmarks when the state accreditors visited last year.

9 On Your Side asked county manager Franky Howard what those benchmarks are, but he said he didn't know.

So 9 On Your Side asked the state health department accreditation board. After six months of waiting, they released their site visitors' report on Friday, showing the Jones County Health Department failed to meet 20% of the state's accreditation requirements.

Among them: the health department had no proof of a communication plan with the medical community in case of outbreak of disease; no training plan for new or current employees; no proof the health department's hours are based on community needs; and no proof of policy on seeking the public's input on health services.

The report also said there was no proof of communication with commissioners on developing health programs, and no proof the board of health has chosen a qualified health director to lead agency.

The health department has an interim health director, Angelica Hall, until a permanent health director is found, said Howard.

The report says high turnover has caused "much stress" among employees.

"You can't possibly have good work performance when you've got that kind of massive turnover," said Mary Martha Rose, a former Jones County Health Department employee who says worked there for 21 years as the WIC director.

Rose says the health department wasn't always like this. "We used to be rocking and rolling," she said.

9 On Your Side asked her why the turnover was so high. "I don't have an answer for that," she said.

Howard didn't want to go on-camera, but he says most of the requirements were being fulfilled. He says there just wasn't documentation because of the turnover.

But former health department employees like Sonia Fogg aren't convinced.

"A lot of people in Jones County, you know, some of them are impoverished, and they don't have the gas money to go all the way to Craven County or go all the way to Lenoir County to seek assistance in health," said Fogg.

The report noted several strengths, saying the facility is clean and well organized, and employees work together well.

But employees reported there are "significant problems" that have to be addressed.

Howard told 9 On Your Side several weeks ago the agency has a few more months to meet those benchmarks, but if not, the state might give them another year to fulfill the requirements.

 

The report says these are the 31 benchmarks failed:

(Activity 3.2) No proof of annual evaluation of agency's hardware and software

(Activity 3.2) No proof of plans for upgrades to improve the quality of health data

(Activity 5.2) No proof of a plan for how the health department will alert the medical community in case of a disease threat with two methods of communication

(Activity 9.5) No proof of documentation for how the health department will notify the affected community members of changes in department policy or operations (in the transfer of maternity patients, no community announcement was made and no opportunity given for community comment prior to or at the time of change)

(Activity 14.2) No proof of documentation showing the department helps commissioners set public health priorities

(Activity 16.1) No proof that the health department directors receive training in current public health law

(Activity 17.3) No documentation showing implementation of control measures (staff reported no control measures implemented in two years)

(Activity 22.3) Department was unable to provide policies and procedures for primary care service provision (health programs) and evidence of primary care oversight

(Activity 23.1) No proof that health director meets legal requirements for the job (evidence provided was from December 12, 2012 minutes that are stamped draft, unsigned, and not in the official minutes book; last board of health meeting was March 12, 2013)

(Activity 24.2) No plan for staff development and continuing education/training (documentation provided was staff development policy, but the policy did not include a plan)

(Activity 24.3) No proof of orientation activities or ongoing training for staff

(Activity 26.2) No proof of plan to recruit and retain staff members supporting non-discrimination policy

(Activity 27.1) No proof of policy or procedure for seeking community input on quality of health services

(Activity 27.2) No proof that community input is being used to make changes to improve services

(Activity 30.8) No proof that health department's hours are based on community's needs

(Activity 31.6) No proof that health department keeps inventory of equipment or plan for replacement

(Activity 32.1) No proof of inventory of hardware and software used with state data management systems

(Activity 33.6) No sufficient proof of health department presenting periodic budget and financial tracking reports to board of health

(Activity 34.1) No proof of operating procedures that comply with state law

(Activity 34.2) No board of health minutes showing the department has reviewed its operating procedures

(Activity 35.1) No sufficient proof the board of health follows procedures for adjudications in G.S. 130A-24.

(Activity 36.1) No sufficient proof that the health department gave health board members written handbook developed or updated in the last year

(Activity 36.2) No training materials provided for new board of health members

(Activity 37.1) No proof the board of health has chosen a qualified health director to lead agency

(Activity 37.3) No proof of discussion of the knowledge and skills needed for health director

(Activity 37.4) No proof of job description for health director job or discussion of job description in board of health minutes

(Activity 38.1) No sufficient proof that the board of health reviews annual reports on community's health

(Activity 38.2) No proof the board of health discussed community health assessment data

(Activity 38.3) No proof of policy on public participation in developing strategy for community health improvement

(Activity 39.4) No proof of communication between commissioners, government agencies, or private foundations on development or evaluation of public health programs

(Activity 40.2) No proof of communication between health department and elected officials on public health intervention

(Activity 41.1) No proof of actions to foster community input regarding public health issues

 

The state accreditors made the following general observations:

  • "During interviews, staff noted their lack of expertise and training in many areas of public health practice and management. In each case, those staff members stated specific actions they would take individually or collectively to meet agency needs and goals."
  • "The Management Team membership has a very short average tenure within the organization and those working on accreditation have only been with the Department a few months."
  • "The SVT [state visit team] recognizes that the high staff turnover during the past two years has contributed to difficulties in providing documentation for accreditation."
  • "Staff interviewed observed that recent turnover has led to much stress among employees, however these interviewees report that situations are already improving…"
  • Interviewees "candidly shared information about significant problems affecting agency operations."

Accreditors noted the following strengths:

  • Much signage geared toward employee safety in obvious places
  • Facility is clean and well organized throughout
  • Interviewees emphasized that current employees are working together well
  • County manager and commissioners appear to be devoting much time and effort to educating themselves on public health organizational models
  • Department has made judicious use of grants to expand services to community
  • Department has had relationships with universities and colleges that is beneficial to agency
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