STRATEGIC HEALTH PLAN (2010-2015)

United Board of Health

Vision

“Healthy People in Healthy Communities”

Mission

“Assuring the Conditions in Which People Can Be Healthy”

 

4C’s Governing Board

Vision

“Healthy People in Healthy Communities with Local Access to Health Care”

Mission

“Provide Access to Quality Ambulatory Health Care to Uninsured and Underinsured Galveston County Residents”

 

April 1, 2010

The Galveston County Health District's United Board of Health and 4C's Governing Board proudly presents the Health District's Strategic Health Plan 2010-2015. The plan was developed inviting the participation and feedback of the general public and community health stakeholders in Galveston County. The Plan addresses seven health priorities identified by participants, and outlines goals that will guide the Health District and community partners towards measurable improvements in the health of Galveston County residents. In an ever-changing health environment, particularly with the recent passage of national healthcare reform, the plan will be updated every five years and the Health District will provide annual progress reports. We acknowledge and appreciate the dedicated work of Health District employees who carried out the planning process. We recognize the need for the support of the entire community in taking positive steps towards improving the health of Galveston County and Cities.

 

Sincerely,

 

 

John A. Zendt, Chair                                                                                      Milton Howard, DDS, Chair

Galveston County United Board of Health                                                         4C's Governing Board

 

Galveston County Health District

Strategic Health Plan 2010 – 2015

Executive Summary

 

On January 29, 2010, Galveston County Health District held a “Forward Thinking Event” as a kick-off to developing a draft Strategic Health Plan for 2010 – 2015.  As a result of the facilitated meeting, key GCHD managers and a 4C’s Governing Board representative identified the following overall draft priorities which were reviewed and updated after United Board of Health and 4C’s Governing Board meetings in late February 2010.  The seven priorities address the following:   

• Improve Access to Care for the Indigent and Uninsured 

• Improve the Health of our Community and Environment 

• Prepare for and Respond to Public Health Emergencies  

• Modernize Facilities and Use of Technology 

• Strengthen the Efficiency and Effectiveness of Business Practices  

• Develop a Competent and Professional Public Health Workforce 

• Continue to Improve and Strengthen the Credibility of the Health District 

In order to assess community perspectives, the Health District conducted an extensive community review and comment period.  Staff attended a variety of community forums including group presentations, meetings with elected officials and employee town hall meetings.  The draft priorities were featured in local newspapers and posted on the District’s website for public comment.  In March, meetings were held with officials in the following member governments of the Health District:

City of Clear Lake Shores

City of Friendswood

City of La Marque

City of League City

City of Texas City

 A list of the individuals and organizations contacted, along with a table of the feedback received, appears as an Appendix to this document.  Three additions were made to the Plan based on feedback from a Board of Health member and two other individuals. 

The final Strategic Health Plan 2010-2015 was approved by the Galveston County United Board of Health on March 31, 2010 and the 4C’s Governing Board on April 1, 2010, to become effective immediately.   

As a culmination of several months of extensive planning involving many health partners in the community, I am pleased to present a plan for health improvements in Galveston County by the year 2015.  Developing an effective health plan would not have been possible without the overwhelming support of members of both of the Health District’s Boards, county and city local elected officials, school representatives, community-based organizations and many others.  I am most proud of the coordinated, behind-the-scenes work of many Health District employees who supported this important effort every step of the way.

Now it is time to implement these health improvements in Galveston County.  Together with our partners, we can make a measurable difference in the health of Galveston County residents!

Sincerely,

 

Harlan “Mark” Guidry, MD, MPH

CEO and Health Authority

Goal One:  Explore opportunities to increase access to 4C’s federally-funded primary care services

• Seek available grant funding that 4C’s may be eligible for
• Explore and implement feasible measures to improve collections and meet state and federal averages for federally-qualified community health centers to generate additional revenues to financially support the care of the patients who are unable to pay for their healthcare
• Continue case manager funding partnership with local hospitals to transition patients discharged from ER or hospital into 4C’s for timely primary care follow-up 

Goal Two:  Partner with county and community leaders to assist in establishing a specialty care network for county indigent patients

 

Goal Three:  Identify barriers and possible solutions to uninsured access to secondary, tertiary, and mental healthcare

1. Convene meetings with community partners to identify barriers at local, state, and federal levels
2. Develop and implement a feasible action plan to inform and educate the public and policy-makers on feasible solutions at all levels
3. Monitor and report progress to boards of health 

Goal Four:  Explore and make recommendations for improving access to pharmacy services for qualified 4C’s patients and alleviate related 4C’s clinic flow obstacles that impact primary care

Goal One:  Timely identification of new and emerging public health threats and public notification about interventions to reduce risk and/or promote health

1. Identify and inform the public about emerging reportable diseases and conditions
2. Identify and inform the public about emerging environmental issues (e.g., mold, “going green,” hazardous household waste, recycling, etc.)
3. Identify and inform the public about ways to protect themselves from animal-related health consequences 

Goal Two:  Prevent or reduce morbidity and mortality by increasing the public’s awareness and use of the Health District’s preventive health program services

1. Educate the public, medical and community partners
2. Expand activities related to public awareness campaigns (e.g., World AIDS Day, World TB Day, women’s health issues, breast feeding, healthy food options for families, child and adult immunizations) 

Goal Three:  Improve the management of communicable diseases in the local health system

1. Educate the local medical community about disease reporting, post-rabies exposure procedures and constraints, use of ImmTrac, etc.
2. Expand efforts to reduce the number of sexually-transmitted infections and TB among highest risk groups
3. Educate the community on various access points for communicable disease screening
4. Improve compliance with state requirements for STD/HIV and TB public health programs
5. Expand education and outreach by (1) integrating awareness activities among various public health programs which serve similar target populations and (2) collaborating with local school districts and faith-based organizations
6. Improve the  accuracy and reliability of STD/HIV and TB morbidity reports comparing those from GCHD epidemiology and the state-funded programs

Goal Four:  Develop an effective response to other new and emerging public health issues (non-communicable) by developing community action plans with stakeholders in the public health system

(Possible Examples: Teen pregnancy and related health risk/consequences, cancer-related health disparities, breastfeeding promotion, obesity, tobacco cessation, chronic disease prevention and management, general health promotion through fitness and a healthy diet, childhood lead poisoning, etc.)

1. Work with hospitals to establish an effective intervention for the treatment of cardiac and cerebrovascular (stroke) emergencies (GAAA)

 

Goal Five:  Design and implement an effective preventive health screening program for registered 4C’s patients (with implementation of new electronic record systems)

1. Develop system alerts and patient reminders for preventive health screenings according to U.S. Preventive Health Services’ evidence-based guidelines
2. Establish system alerts and accurate data collection for management of chronic conditions such as diabetes and hypertension

 

Goal Six:  Recognize and promote best practices for health promotion among local governments, businesses, and community-based organizations

(EXAMPLES: city no-smoking ordinances, food services with exceptional health and safety practices and healthy menu choices, businesses with wellness programs, etc) 

Goal One:  Inform, educate, and empower the public to prepare for health needs before, during, and after an emergency

• Implement use of Connect CTY to accomplish the following objectives:
• A web based  system for the general public to sign up for Health District information
• Ability to communicate with multiple groups via various forums (i.e. telephone calls, text messages or email)
• Continue to disseminate public information through established media outlets

 

Goal Two:  Evaluate the effectiveness of GCHD medical reserve corp (volunteers for health emergencies) and make recommendations to improve the number of capable volunteers available to call upon in an emergency event

1. Implement new volunteer program
2. Develop essential training materials for volunteers using available technology

 

Goal Three:  Collaborate with community health partners that share roles and responsibilities in various types of emergency responses

1. Seek environmental inter local agreements for mutual aid during disasters with local and state agencies to clarify roles and responsibilities

 

Goal Four:  Seek to acquire needed equipment and supplies through state or federal grant funding to effectively respond to various types of emergencies, considering all GCHD program responsibilities

 

Goal Five:  Work with stakeholders in the public health system to address solutions to the Health District’s lessons-learned from Hurricane Ike

• Convene meeting of multi-agency response partners
• Update GCHD emergency operational plans and program specific guidelines
• Provide annual employee training
• Improve administrative support of emergency response needs as they occur

 

Goal six:  Assure contract compliance through centralized tracking of reportable activities and progress (funds managed through public health preparedness grants)

FACILITIES

Goal One:  Build new or renovate existing facilities to meet public service needs

• New animal resource center to accomplish the following objectives:
• Increase total animal holding capacity from 78 to 257
• Increase health and safety of staff, animals and visitors
• Decrease transmission of disease in the animal population
• Expand and update the animal services policy, guidelines and needed resources to manage the expanded services

 

• New Mid-County Annex to consolidate services in four existing facilities (1207 Oak Street in La Marque, 1205 Oak Street in La Marque, 2000 Texas Avenue in Texas City; and the public health services at 4700 Broadway in Galveston) with the following objectives:
• Improve public access to services
• Consolidate staff with similar functions in various programs to establish a one-stop GCHD business center
• One way in and one way out of the 4C’s clinic with improved security and flow of patients
• Improved storage for emergency supplies
• Improve disaster recovery of governmental records
• Establish a clinic for public health clinical services, separate from 4C’s (STD, TB, and breast exams)
• Establish a modern immunization clinic that will accommodate large events

 

• New EMS Stations in Hitchcock, Bacliff and  Galveston’s 26th & Q
• Renovate Galveston 4C’s clinic for improved productivity and clinic flow
• Consider expansion/renovation of Galveston WIC clinic in Island Community Center

TECHNOLOGY

Goal One:  Complete three-phase roll-out of new electronic business, medical record and dental record systems for the 4C’s clinic to accomplish the following objectives:

1. Minimize impact to patient care
2. Minimize rollout confusion by clarifying roles, responsibilities and decision-making processes
3. Centralize communication to NextGen
4. Standardize & simplify work processes
5. Move all possible from paper to electronic
6. Improve billing and collections
7. Improve quality of care and documentation
8. Realize efficiencies in work processes and staffing
9. Improve customer services

Goal Two:  Complete rollout of new animal services software to accomplish the following objectives:

• A fully integrated animal services data management system that links animals and their owners, tracks bite cases, manages pet registration information, manages adoption paperwork, monitors lost animal reports and integrates with adoptable pet web sites.
• Electronic tracking of animal owner’s compliance history
• Interfaces with the Health District’s Accufund accounting software
• Capable of creating improved local jurisdiction reports (which form the basis of the inter-local agreement’s formula for county/cities’ budget contributions) 

Goal Three:  Complete upgrade and expansion of new accounting/payroll system to accomplish the following objectives:

1. Achieve efficiencies in reducing staff time performing manual and duplicate entries
2. Electronic personnel record system integrated with payroll
3. Electronic documentation for required employee immunizations and trainings
4. Establish appropriate management level access and permissions
5. Establish electronic purchasing and timesheets
6. Integrated system for fixed assets tracking
7. Improve management reports
8. Enable integration with other software (i.e. NEXTGEN, EnvisionConnect, Shelter Pro)
9. Ability to set up electronic computer-based cash drawers for all program areas (replace old cash registers) 

Goal Four:  Explore and implement use of other technologies to improve public health services and GCHD business efficiency/accountability (e.g., improve data quality)

1. Implement a Contract Management Software program to handle the volume of contracts and improve internal access
2. Explore opportunities to acquire an electronic medical records system for local and state and funded breast and cervical cancer screening programs (public health)
3. Explore opportunities to enable online disease reporting for hospitals and schools
4. Explore an electronic applicant tracking system to improve hiring process
5. Investigate and identify new data security systems that monitor network intrusion detection, identify where network security breaches occur, etc.
6. Investigate and identify ways to electronically file and store required government documents

Goal One:  Develop employee training programs on issues of significance to the 2010-2015 Strategic Health Plan, including but not limited to:

• Roles and responsibilities of governmental public health and healthcare services
• Effective communications with public members and best practices for excellent customer services
• Train 4C’s cashiers on effective communications necessary for optimal collections
• Nursing updates on immunizations practices and new vaccines
• Dealing with difficult complaints and customers
• Job-related training on all newly implemented electronic systems

 

Goal Two:  Continue efforts to recruit and retain qualified human resources in key areas of the Health District, including but not limited to:

1. Perform market-based salary analyses on, at minimum, positions with highest turnover rate and greatest difficulty recruiting (e.g., 4C’s nursing staff)
2. Volunteers and health professions with educational rotations at the Health District

• Evaluate and improve the comprehensive orientation training for all new staff
• Annual training to meet legal requirements and to promote goals in the Strategic Health Plan (e.g., customer services, safety, blood-borne pathogen exposures, protected health information, sexual harassment, discrimination, agency communications, emergency operations, etc.)
• Management training for new managers or those requiring professional development in areas such as, but not limited to, personnel management, interview and selections, employee evaluations, and policy responsibilities of managers
• Redesign and update policies and information on the intranet
• Promote employee wellness activities for employee betterment

 

Goal Three:  Explore all options for making available job-related continuing education where required

 

Goal Four:  Establish a Supervisory/Management Training program

• Overview of GCHD:  mission, roles, policies (e.g. ethics, etc) and management expectations
• Effectively conducting employee evaluations
• Effective management of personnel issues according to policy and laws
• Effective inter-office communications

 

Goal Five:  Establish a mentoring program for new employees and those requiring professional development

Goal One:  Inform and educate local governments and elected officials about relevant information that impacts health policy and related decision-making

1. Prepare and submit an environmental risk assessment for county and member city jurisdictions
2. Inform and educate city officials about health policy options to reduce public health risks (e.g., no smoking ordinances, etc) 

Goal Two:  Improve the quality and availability of official information for the general public and local partners

1. Proactively share health promotion information with the public about relevant community and environmental health topics (e.g., going “green,” wellness, preventive health screening, etc)
2. Explore strategies to reach new segments of the general public (e.g., door-to-door outreach education, Connect CTY technology, Facebook, Twitter, website videos, etc) 

Goal Three:  Improve the responsiveness of the Health District to health inquires and concerns of the general public and community stakeholders

1. Prepare, disseminate, and post on website a list of frequently asked questions regarding the Health District and contacts for various types of public inquiries
2. Prepare and disseminate to stakeholders the average response times of animal control officers to citizen calls for assistance with or about stray dogs and cats
3. Prepare reports to boards on types of citizen calls to the executive office along with recommendations for improvements 

Goal Four:  Assure Health District investigators objectively identify and document relevant investigative findings based solely on official standards consistent with local policies and regulations

1. For all GCHD programs conducting health investigations set expectations so that standards and methods used are objective, policy-based, and documented properly for compliance with contracts and/or state/federal expectations
2. Complete standardization of consumer health inspections and annually evaluate compliance 

Goal Five:  Improve public perceptions about quality of care and customer service in the 4C’s clinics

1. Prepare and submit a comprehensive improvement plan to the 4C’s Governing Board for consideration 

Goal Six:  Engage the public and health partners in addressing shared health goals

1. Maintain and convene community group meetings to address various priority health issues (e.g.,  obesity, lead poisoning, air pollutants, etc.), utilizing electronic technology to share ongoing information
2. Work with community stakeholders to explore technology to share data to improve care management of patients who access primary, secondary, and tertiary care services among various agencies in the local healthcare system (e.g., shared electronic data repository project)
3. Engage animal interest groups and public volunteers to participate in any new and existing services at the expanded new animal resource center

 

Galveston County Health District

Strategic Health Plan 2010-2015 Draft Feedback

 

The following organizations and individuals received presentations on the Draft Plan or were directly contacted by GCHD Executive Staff and were provided the Plan with a request to provide feedback by 3/30/10:

• All Galveston County City and County elected officials
• Galveston County Medical Society
• Public Information Officers of all Galveston County school districts
• Superintendants of all Galveston County school districts
• School nurses of all Galveston County school districts
• Galveston County Local Emergency Planning Committee
• John Simsen, Galveston County Emergency Management
• Galveston County Emergency Managers
• Galveston County Emergency Response Collaborative
• Texas City-LaMarque Community Advisory Committee
• Regional LULAC
• Galveston County Childhood Obesity Partnership
• Galveston County Senior Health Advisory Committee
• Galveston County Animal Advisory Committee
• UTMB Center to Eliminate Health Disparities
• Social Service Block Grant social service and community organizations  (10+ agencies) 
• Hospitals, nursing homes, first responders and city officials involved in EMS service agreements
• Gulf Coast Center MHMR
• Coastal AHEC 
• Jesse Tree
• Mainland Youth at Risk
• Aids Coalition of Coastal Texas
• Pathway to Recovery
• ADA House
• Bay Area Recovery Center
• Women’s Health Center at Mainland Medical Center
• Janice Winnike, RN, UTMB Geriatric Clinic
• Darlene Cass, RN, Jesse Tree diabetes educator
• Dr.  Ana C. Triana, UTMB Family Medicine Department
• Judith  Dimarco, Administrator, UTMB Family Medicine Department
• Dr. Harvey Bunce, UTMB PMCH
• Laura Rudkin, UTMB PMCH
• Infection control staff at local hospitals:  Mainland Medical Center, UTMB, Shriner’s Burn, Christus St. John’s
• Members of the Galveston County Lead Taskforce
• Galveston County Immunization Advisory Council
• Galveston County Daily News (editorial published Sunday, 3/6/10, asking for public comment)
• Guidry News
• The Post newspaper, Texas City
• Galveston Morning Kiwanis
• Town Hall Meeting 4C’s Clinic Staff
• Town Hall Meeting GCHD Public Health Staff
• Town Hall Meeting Galveston EMS Staff

 

Color code:  Yellow applies exclusively to the 4C’s Governing Board

Red print denotes a proposed modification to the Strategic Health Plan draft

 

 

Organization and/or individual	Feedback Provided	Relevant priority/goal/activity	GCHD Response
Galveston County City and County Elected Officials
City of LaMarque Mayor Geraldine Sam	Supports SHP priorities Requests animal services to look for stray dogs along Stonewall, Jackson and Thompson streets in LaMarque GCHD should submit health topics to LaMarque newsletter Assure transportation of LaMarque residents to new Texas City 4C’s clinic location when it moves to the Mid-County annex Provide SHP presentation to the LaMarque City Council on April 12 Provide assistance to organize a Saturday “health day” event in LaMarque to focus on diet and fitness, fresh fruits and vegetables, exercise demonstrations, oral health education, referrals and education about 4C’s, health screenings, possibly in a city parking lot at the end of September or October, partner with the schools and offer awards and recognition	Modernize Facilities and Use of Technology.  Complete roll out of new animal services software.   Improve the Health of our Community and Environment.  Prevent or reduce morbidity and mortality by increasing the public’s awareness. Improve Access to Care for the Indigent and Uninsured Continue to Improve and Strengthen the Credibility of the Health District	These comments validate the Strategic Health Plan draft as written.
City of Texas City Nick Finan, Executive Director of Management Services	Discussed the possibility of consolidating city vital statistic operations with GCHD. A meeting with Mayor Doyle is scheduled April 5.	Strengthen the Efficiency and Effectiveness of Business Practices.  Explore opportunities . . .to consolidate administrative functions to achieve efficiencies (goal).	These comments validate the Strategic Health Plan draft as written.
City of Friendswood Nick Haby, Assistant City Manager	He understands the Plan and desires to strengthen the relationship with GCHD. Discussed animal resource center as City of Friendswood explores options for animal services He supports use of Connect CTY He was added to GCHD’s distribution list for city officials for health news and alerts.	Modernize Facilities and Use of Technology. Prepare for and Respond to Public Health Emergencies.  Implement use of Connect CTY (activity). Continue to Improve and Strengthen the Credibility of the Health District.  Inform and educate local governments and elected officials about relevant information that impacts health policy and related decision making (goal).	These comments validate the Strategic Health Plan draft as written.
City of Clear Lake Shores Paul Shelly, City Administrator, Mayor, Council Member	No issues with GCHD and plan Requested animal services be more visible in their city and let them know when in area Requested information about new resource center and future cost to cities operate Agree to appoint member to Animal Advisory Committee to assure information gets to city and city feedback considered	Improve the Health of our Community and Environment.  Identify and inform the public about ways to protect the public from animal-related health consequences. (activity). Modernize Facilities and Use of Technology.  Complete rollout of new animal services software (goal). . . . capable of creating improved local jurisdiction reports (activity).	These comments validate the Strategic Health Plan draft as written.
City of League City Marcus Jahns, Interim City Administrator	No issues with GCHD Will move to get agreement with Harris County to regulate septic system among the residents of League City within Harris County Gets mosquito control complaints – may be better managed under GCHD     Expect increase in food service inspections over next 5 years, along with increasing development along I-45 City economic interest in restaurant businesses within League City Appreciate H1N1 shots to city residents	Continue to Improve and Strengthen the Credibility of the Health District.  Inform and educate local governments and elected officials about relevant information that impacts health policy and related decision making (goal). Strengthen the Efficiency and Effectiveness of Business Practices.  Identify new personnel and resources needed by the Health District to accomplish Strategic Health Plan goals and objectives, and explore available funding options.	These comments validate the Strategic Heath Plan draft as written.
Galveston County School Districts
Dickinson ISD Leland Williams, Superintendant	I think the priorities are all worthwhile, and well developed. However, perhaps the last one, regarding the strength and credibility of the Health District, would best be served by focusing on the other 6 priorities. The last one seems a bit self-serving to me, although the activities listed under that priority are certainly worthwhile.  However, those activities could be distributed under other priorities. A viable entity need not expend time or other resources for self-preservation initiatives.  The Health District has established a reputation for being responsive and responsible--what more do we need from the District?  Good work!	Continue to Improve and Strengthen the Credibility of the Health District	GCHD acknowledges the feedback.  This priority is more of one to provide guidance to GCHD employees regarding the goals and activities deemed essential to continue our efforts to improve our credibility to the public, particularly during emergencies (such as disease outbreaks,) but also beneficial in routine operations.  We do appreciate being made aware of this perception and will work to educate the public regarding the primary purpose of this internal priority.
Galveston ISD Talisa Comeaux, RN	Sounds good- I wish that the Bolivar Peninsula could have a clinic such as the 4C’s.  Something small- maybe 3 times a week. UTMB talked of having a Mobile Health Unit here once a week, but I haven’t heard anything else. We are in need of easy accessible health care over here.	Improve Access to Care for the Indigent and Uninsured. Explore opportunities to increase access to 4C’s federally-funded primary care services (goal).	We appreciate the feedback and will modify the activity under the goal to read “Seek available grant funding that 4C’s may be eligible for, to find new access points in the county.” See SHP draft page 2, first goal, first bullet
Community Agencies and Organizations
Galveston County Emergency Response Cooperative	Members support the Strategic Health Plan and especially this priority.	Prepare for and Respond to Public Health Emergencies.	This comment validates the Strategic Health Plan draft as written.
Gulf Coast Center MHMR Sarah Holt, BSN, RN, Director of MH Adult Clinics	Gulf Coast Center would, of course, like to continue the existing partnership with the Galveston County Health District for the continuation of the on-site GCC mental health outreach worker.  As you know, this partnership the GCC Outreach Case Manager has afforded us the opportunity to expedite medical home referrals for our mental health consumers with co-occurring medical conditions.  Additionally, this partnership has provided us easy access to a primary care provider for individuals with “mild” (non-priority population) mental health diagnoses; thus, allowing for treatment openings at GCC for individuals with severe and persistent mental health diagnoses.  We are extremely grateful for this ongoing partnership.  We would certainly welcome any opportunity to collaborate with 4C’s and other local public health entities for the integration of primary health and behavioral health care for individuals in Galveston County.	Improve Access to Care for the Indigent and Uninsured Identify barriers and possible solutions to uninsured access to . . . mental healthcare (goal).	These comments validate the Strategic Health Plan draft as written.
SSBG Grant Social Service Agencies Stacey Monroe, ECI Launch	Really comprehensive!  It sounds like the GCHD is moving forward in many ways – exciting!	Entire draft Strategic Health Plan	This comment validates the Strategic Health Plan draft as written.
Coastal AHEC (Leslie Hargrove)	She suggests using social networking to get the health messages out:  Facebook, Twitter, texting, etc.  AHEC would like to partner with the Health District in the following ways: Supply Community Health Workers (trained lay people) to work with Community Health Programs or the clinic.  They can be used to do outreach, help people apply for programs like CHIP, Medicaid, etc and other jobs. Supply some employee inservice materials – AHEC has developed training programs on customer service and other topics.  She will let me know other topics. AHEC can supply presentations and ideas for the Employee Wellness Program. AHEC can (continue to) place health professional students/volunteers in the clinic and in public health programs.	Improve the Health of our Community and Environment (Public Awareness goals).  Prevent or reduce morbidity and mortality by increasing the public’s awareness and use of the Health District’s preventive health program services (goal).  Developing a Competent and Professional Public Health Workforce.  Develop employee training programs on issues of significance to the 2010-2015 Strategic Health Plan (goal).  Promote employee wellness activities for employee betterment (activity).  Continue volunteers and health professions with educational rotations at the Health district (activity).	These comments validate the Strategic Health Plan draft as written.
Darlene Cass, RN, Diabetes Educator for Jesse Tree	I live in Galveston County and for the last 9 years have been employed and/or volunteered in Galveston County as a health educator. My original focus was diabetes education and currently this has expanded to all chronic conditions.  I would like to see more emphasis on disease prevention and healthy living education, and community wide diabetes and cardiovascular classes. My experience has been that the participants in my classes do not have basic knowledge about their disease, nutrition, exercise and medications.  This lack of information spans all economic and ethnic groups. A focus on prevention education and disease specific education is necessary to have a healthier community.  I would like to see a stronger statement related to expanded preventive and disease specific education for the Strategic Health Plan.	Improve the Health of our Community and Environment.  Expand education and outreach by (1) integrating awareness activities among various public health programs which serve similar target populations and (2) collaborating with local school districts and faith-based organizations (activity).	We appreciate the feedback and we will revise the activity to include “explore partnering and/or a pilot with Jesse Tree to expand preventive and disease specific education.”   See SHP draft page 3, third bullet
General Public
Anonymous caller responding to newspaper editorial asking for public feedback.	More cashiers are needed in the clinics.  There should be at least 4 cashiers on duty at all times. More dentists and dental assistants are needed.  We also need more than one dentist who comes in part time to make and deal with dentures.  Dental services are very inconvenient.  New technology is needed for registration.  There is no reason the process should take more than 15 minutes. The clinics need to take in walk-ins everyday in a separate place since most county residents do not have primary care physicians or insurance.  Patient records should be in some electronic format so it is easier for each person looking at the record to know what the patient has had done, or is being seen for. There should be a new procedure for pharmacy so it does not take so long for patients to get their prescriptions.  There should be a cashier just for pharmacy. Actually every area should have a cashier. Staff is not courteous or friendly and many should not have the jobs they have, they are rude. This is why so many people just opt not to visit the 4c’s clinics.	Improve Access to Care for the Indigent and Uninsured Explore opportunities to increase access to 4C’s federally-funded primary care services (goal). Modernize Facilities and Use of Technology.  Improve public access to services.  Complete the three-phase roll-out of new electronic business, medical record and dental record systems (goal). Strengthen the Efficiency and Effectiveness of Business Practices.  Assess and evaluate public/customer feedback regarding the quality of services provided (goal).  Developing a Competent and Professional Public Health Workforce.  Continue to Improve and Strengthen the Credibility of the Health District.  Improve public perceptions about quality of care and customer service in the 4C’s clinics (goal).	These comments validate the Strategic Health Plan draft as written.
Jack Cross	Thanks for including me, but I don't have anything to add, it seems the health district is doing a good job and I am impressed that you want to stay ahead of the curve and solicit the public's input.  You have my support in your efforts.	Entire draft Strategic Health Plan.	These comments validate the Strategic Health Plan draft as written.
Natha Nuckols	Will you be receiving the money that is being collected from property owners?  Why can't your office manage the City and County employees’ health needs, instead of our tax dollars going to Tennessee, for their health care clinic? $150,000 per year from the City alone should help your office. That's what the City spent on this health clinic 2008.  Can't you locate/attach your website on each City's website?  I don't know where you're located or how people know you exist.	Continue to Improve and Strengthen the Credibility of the Health District	The formation of a Hospital District was deliberated last year and the Commissioner’s Court made a decision not to create a Hospital District.  Therefore, no new property tax dollars are involved. Your suggestion will be shared with the appropriate city and county officials. Our Public Information Officer regularly looks for opportunities to connect GCHD website to those of the cities.  Currently cities with websites that connect include Galveston, Texas City, Dickinson, LaMarque, Santa Fe and Galveston County.  We are seeking to link our site to the rest of the cities with websites. GCHD will continue to educate the public regarding our services and various locations.
Anonymous call, 4C’s Patient	She is 39, single, no children, not working.  She said we need some kind of medical plan for people like her who fall in-between.  She goes to the 4C’s but you have to wait all day for care and there is nowhere else for someone in her situation to go for care.  She was told to apply for Women’s Health but it doesn’t pay for anything she said only Pap smears.  She does not qualify for temporary Medicaid.	Improve Care for the Indigent and Uninsured	These comments validate the Strategic Health Plan draft as written.
GCHD Employees
Geneva Dunaway, Dental Hygienist	I think it would be favorable if we could offer more information to patients about the importance of their dental health because it has an overall impact on their general health.  For example, it would be good to have the relationship between oral health, heart disease, stroke and diabetes presented in other departments, not just the dental department.  One area I think that could be strongly improved is in encouraging parents to bring their children in at an early age for dental care so that we have a chance to educate the young and u-coming generation and hopefully teach them how important good dental care is and how to take care of their teeth and improve their total body health.  One way to incorporate this is by participating in Children’s Dental Health Month, which is a national campaign that takes place every February.  The World Health Organization also recognizes the problems we have here, quoting from the World Oral Health report 2003.  In the U.S. “dental caries is the most common chronic childhood disease, being 5 times more common than asthma.”	Improve the Health of our Community and Environment	These comments validate the Strategic Health Plan draft as written. The electronic dental record planned for implementation in 2011 will be an excellent tool to provide standardized dental health educational materials.
Rozzie Smith, Lab Tech	How can we let patients in the 4C’s clinic know that they should continue to come in for health care if they don’t currently have the money to pay for their co-pay.	Improve Access to Care for the Indigent and Uninsured	Each clinic patient is educated by the Patient Services staff on initial registration that they are not to be refused services based on inability to pay.  A patient’s ability to pay is determined by a financial screening performed in registration.  Patients with questions about their bills should be referred to the billing and collections staff.  Patients with other financial or social barriers should be referred to  the case managers.
Amita Chawla, Epidemiology Investigator	Workplace recycling/going green initiatives A statement about improving pet adoption to the animal resource center. I think that is an important/relatable aspect of the resource center that should be specifically identified Education reimbursement under “Developing a competent and professional public health workforce.” Education reimbursement is common among many government and private entities. It encourages current staff to better their understanding of public health and serves as a great recruiting tool for future public health leaders.	Modernize Facilities and Use of Technology.   Improve the Health of our Community and Environment.   Develop a Competent and Professional Public Health Workforce	These comments validate the Strategic Health Plan draft as written.  The Strategic Health Plan draft shows commitment to do all that is fiscally feasible to develop a competent workforce.
Jim Hilton, STD/HIV	Workplace recycling must be more convenient than simply throwing things away in the regular trash.	Modernize facilities and use of technology.   Improve the Health of our Community and Environment.  Identify and inform the public about emerging environmental issues (activity).	This comment validates the Strategic Health Plan draft.
Shirley Carr, Volunteer Coordinator	The draft Strategic Health Plan for 2010-2015 is very good. It really covers all aspects of the Health District. The committee did a great job.	Entire draft Strategic Health Plan	This comment validates the Strategic Health Plan draft as written.
Tiffany Rice, WIC Director	The primary goals of the WIC program are to assist families in eating well, educate about nutrition and nutritious foods, and assist with access to care.  All of these objectives have been outlined in the 2010-2015 draft and are being implemented through WIC policy as well…	Improve Access to Care for the indigent and Uninsured. Improve the Health of our Community and Environment.  Prevent or reduce morbidity and mortality by increasing the public’s awareness and use of the Health District’s preventive health program services (goal).	This comment validates the Strategic Health Plan draft as written.