Q&A Kevin Gipson, Director of Health, Springfield-Greene County Health Department

Gipson: The largest amount of our time is going to be spent dealing with issues related to emerging infectious diseases - specifically putting together a plan to deal with a possible pandemic flu. What's going on in Turkey now, what's been going on in Asia, really has the public health community very concerned, and we are working with our health care facilities, Missouri State University and other key players in the community to help deal with the possibility of a major flu outbreak, whether it be bird flu or another strain of flu that could cause serious illness in our community.

SBJ: The Health Department does provide some flu shots each year, correct?

Gipson: Yes, through a couple of programs. We work with our community coalition that's led by the Greene County Medical Society (and) all three hospitals - Doctors Hospital, St. John's and CoxHealth - and the school nurses. We pool our resources every year to do public clinics. The first (flu shot) clinics of the year are done by this coalition, and we provide a number of flu shots to those at risk after those clinics are done.

SBJ: However, immunizations are only one piece of the puzzle in being prepared for a possible outbreak?

Gipson: Absolutely. It's a very comprehensive and complicated process. Number one, we have to be always diligent in our surveillance efforts to try and figure out what's going on in our community, not only with flu, but with other diseases. We know every day the occupancy rate of the hospitals, how many people went to the emergency room. We know the number of deaths that are reported at each hospital. We know how many upper respiratory infections, we know how many gastrointestinal distress issues happen in the hospitals. We're always looking for something that would lead us to believe there could be an outbreak looming. Or the possibility, and it may be rare, that there would be some kind of intentional release or activity, a bioterrorism event that we need to locate. Then, we have to put together plans for (dealing with it) because the hospitals will be pretty much closed down. They'll be inundated. Who's going to be able to go to the hospital? Who won't? Do you set up special camps or facilities or places where you triage patients? How do you care for people who are sick? … Then the issue (becomes) if there is an immunization or a treatment, how quick can we get it, and how do we dispense it to the general public? It's a very complicated and monumental task.

SBJ: What effect have Medicaid cuts had on Health Department operations?

Gipson: Starting Jan. 1, we have gotten out of the primary health-care business. We used to run a large indigent health care clinic here for people without any insurance. We did not accept Medicaid. These were people who were truly indigent, very poor, and it was means-tested based on their income. It was a very low-income threshold. We have since transferred all of that (service) to Jordan Valley Community Health Center, along with resources. We believe that by pooling resources … we can help more people. We really had never taken any adult Medicaid to speak of. Most of the Medicaid that we receive - about a quarter of a million dollars last year out of a $7 million budget, which is not a great deal - comes from what we've gotten from serving children, primarily through immunizations and school-based clinics.

SBJ: What are some new programs or efforts the Health Department will work on in 2006?

Gipson: We have a great relationship with our hospitals, Jordan Valley Community Health Center, The Kitchen, and we really are working together to try to put together a system of care for those who have limited access (or) no access to health care. About five years ago, we had a dream, before Jordan Valley Community Health Center became a reality, to put a community health center in this community to help deal with those who have limited access.

SBJ: What are some other key objectives the Health Department has for 2006?

Gipson: This is a city and county operation, so we are very interested in the growth that's going on in the county - food service, environmental issues. We're working very closely with the county commission to help address some of those issues.

We have a very dedicated and model environmental program in our city. We'll be moving all of our environmental health programs over to the remodeled Christ Science Church on Central. It's a major project that will help us be more efficient.

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