health serviMountain Xpress

As part of a major reshuffling, the Buncombe County Health Department will move from 35 Woodfin St. to the Human Services Building (40 Coxe Ave. in downtown Asheville) next year. In the meantime, the department is providing services at these interim sites:

Harris echoes those sentiments.

At the end of this school year, the department plans to close its student health centers at Asheville and Erwin middle schools and Asheville High. To help with the transition, three county nurses will be placed in those schools full time. Still, Harris acknowledges that the change will cut the county&39;s ability to deal with "episodic care &8212; the sore throats, the ear infections, the sports physicals, those kind of things."

Ten of the department&8217;s 49 remaining nurses will see their duties change as part of the redesign, she says. The plan is to focus their efforts on "really core public-health issues that we need to deal with," such as ually transmitted and communicable diseases, mily planning and student health.

&8226; Inspections and permits: Food, water and sewer permitting and inspections will remain at their current location (30 Valley St.)

&8226; Administrative offices and vital records (59 Whealth serviMountain Xpressoodfin Place)

3) WNC Community Health Services (257 Biltmore Ave. &8212; WNCCHS patients only).

Amid tight budgets and tough economic times, the Buncombe County Health Department continues to implement major changes.

Jennifer Mullendore will replace Yancey as medical director; come July, she&39;ll be the only physician left at the Health Department. The county will also lose three nursing positions: One is retiring; the others have accepted jobs elsewhere, notes Harris, adding, "We&39;re not quote-unquote &8216;laying folks off.&8217; &8230; When it&39;s all said and done, they&39;ll all still be employed if they choose to be. &8230; The reduction of those three nurses should not hurt us."

"I think this recession is one of the hardest times that I&39;ve lived through in public health," Yancey acknowledges. "But with all of this integration and innovation, I think there&39;s real possibilities for focusing and doing more good for the public&39;s health than ever before. We have studied so hard the core services that public health has to ensure in this county."

In January 2010, many of the department&39;s physicians and prenatal services were transferred to the nonprofit Western North Carolina Community Health Services, which qualifies for a higher federal-reimbursement rate. And Cynthia Yancey, a staff physician for 23 years before taking over as the county&8217;s medical director last year, says she&8217;s preparing to follow many of her former co-workers "back into the trenches" at WNCCHS; she&39;s retiring from her Health Department job and will start work as a prenatal physician at the nonprofit in July.

Buncombe County, notes Yancey, has the highest immunization-exemption rate in North Carolina: As of last year, 4.02 percent of the county&8217;s children weren&39;t vaccinated. Statewide, the average is 0.82 percent. Many of those cases, she explains, involve parents who claim religious or medical exemptions, fearing that immunizations do more harm than good. Yancey believes this has contributed to the continuing local pertussis outbreak: 66 cases have been reported over the last six months. In response, the county has launched a marketing campaign to educate the public on the importance of immunizations, and has formed an immunization-exemption committee to study the issue further.

&8226; Family planning, prenatal health, breast and cervical cancer) and Wise Woman programs (53 S. French Broad Ave.)

&8226; WIC Nutrition now has three locations:

Despite all the challenges, both Yancey and Harris say they&8217;re hopeful about the future.

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&8226; Community health programs: Health promotion, STD, school-health nursing and social-work programs remain at 35 Woodfin St. on the lower level.

Instead, the focus will shift to prevention: &8220;Working specifically with those high-risk and special-needs children to make sure they&39;re getting the care they need," she explains. "Working with milies to make sure their children are vaccinated so they can be in school."

The change, she explains, "is not only logical for all of us but will help to assure safety-net care over there, because I&39;ve done it here for so long, and I&39;ll just be doing it under a different roof. It&39;s another logical transition for me, toward the end of my career, to help others take that over. &8230; WNCCHS is a good clinic."

The reconfiguration involves shuffling departments, services and staff. By January 2012, the department expects to leave its longtime home at 35 Woodfin St. in downtown Asheville, relocating to the renovated Human Services Building (40 Coxe Ave.). Meanwhile, the department is operating out of several interim sites (see sidebar, &8220;At Your Service&8221;), increasingly relying on outside partnerships to deliver primary care.

For more information, go to buncombecounty.org or call 250-5000 for appointments.

"The intent behind all of this is to focus ouhealth services careerr work and do what we do really well," she maintains. "Our focus has to be on prevention and education, and working with specific populations to make sure they&39;re as healthy as they can be."

health serviMountain Xpress,"We&39;re in the process of redesigning and refocusing the work we do to really focus on the core public-health issues in our community," Health Director Alma "Gibbie" Harris reports.

"Our teen-pregnancy rate is a little more than double what the national benchmark is for that. And our STD rate is three to four times higher," notes Harris.

1) 297 Haywood St.

2) Human Services West (339 New Leicester Highway).

&8212; Jake Frankel can be reached at 251-1333, ext. 115, or at .

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