News Photo by Kayla Wikaryasz On Tuesday, District Health Department No. 4 board members are seen sitting in the Presque Isle Company Commissioners’ Room during this month’s board meeting. Budget concerns, rabies prevention, dental healthcare, and other updates were discussed.

ALPENA — At the May District Health Department No. 4 (DHD4) meeting held Tuesday, board members discussed budget concerns, rabies prevention, dental healthcare, and other miscellaneous department updates regarding programs and vacant staffing positions.

Dr. Joshua Meyerson, DHD4 medical director, started off the meeting by discussing the importance of rabies prevention, especially in children. Meyerson said that rabies is unique in that it affects all humans equally.

“The problem with rabies is, when someone’s sick with rabies, it is uniformly fatal,” Meyerson said.

Meyerson explained that rabies is a viral disease and is transmitted to humans mostly through bat bites. He explained that it is rare for humans to contract rabies from cats and dogs. On the other hand, squirrels, mice, and hamsters do not carry rabies.

“Rabies is a viral disease that (affects) most mammals, and it’s usually transmitted through the bite of an animal who is actively infectious with it, usually a rabid animal,” Meyerson said.

Meyerson noted that a hospital visit for a rabies infection can cost up to $15,000 to $20,000, adding a financial burden to a life-threatening situation that can be prevented with a vaccination.

Due to the prevalence of rabies in bats, if an individual is bitten by a bat, Meyerson said the animal should be captured and euthanized. The protocol is for the DHD4 to send the bat to state testing laboratories in Lansing to determine if the animal was, in fact, infected with rabies.

Meyerson said that the turnaround to get determination of rabies is quick.

Towards the end of the meeting, Denise Bryan, DHD4 administrative health officer, discussed the ramifications of potential cuts to the CDC, which would impact DHD4. A current federal budget proposes a 50% cut to the CDC budget, thus causing a trickle-down effect to local-level health departments. She explained that the federal budget can still change per Congress’s wishes.

“Congress has the power of the purse, and we will have to wait and see what our elected officials end up doing with the budget at the national level…We don’t want to wait until October 1 to be surprised by anything,” Bryan said.

Bryan said that the DHD4 should expect a state budget by June, but might not see it until August or September. Because the DHD4 uses previous year budgets to base new budgets on, Bryan said the approaching budgeting process will be more complicated as the department braces for potential federal cuts.

“There’s so many of our programs listed on the hit list,” Bryan said. “How do you really even do a feasible projected proposed budget (for) your board?”

To prepare for potential cuts, Bryan requested a motion to close a non-mandated program called the Maternal Infant Health Program (MIHP) that brings nurses into the homes of mothers and infants to provide preventative care. After losing the required social worker personnel to run the program, the DHD4 faced the decision of either requesting a nine-month grace period to operate without a social worker or discontinue the program.

After looking at the finances, Bryan explained that the department does not receive any state funding and instead, the DHD4 county appropriations fund this program. While pulling receipts, Bryan was skeptical that the dollars put forth to fund MIHP were the most effective use of their budget.

Bryan also explained that the caseload of MIHP has dwindled since COVID, and more parents are becoming skeptical of DHD4 nurses.

“Just getting nurses into the home can be a real struggle,” Bryan said. “We had some nurse fluctuations…some people do associate us as being government workers (they think) we’re going to do a CPS report to look at the dirty dishes or return bottles that sit by the door, and it makes people nervous.”

Bryan explained that $77,000 of DHD4’s county appropriations budget goes to the program, and it currently serves 35 cases.

Therefore, Bryan’s estimation was that the best use of DHD4 money was to reappropriate MIHP money for more popular programs such as the Women, Infants, and Children (WIC) program, infant immunizations, and family planning, where the DHD4 can have more of an impact.

According to Bryan, nurses who work in MIHP will not lose employment, but rather, they will be reappointed to other programs within DHD4.

IN OTHER BUSINESS

— Kevin Prevost, DHD4 environmental health director, took time to discuss a new DHD4 online environmental health portal available to the public to view evaluation records of campgrounds, food establishments, and pools. The online portal can be accessed at dhd4.org/enviormental-health.

— Kelly Girard, DHD4 nursing director, discussed updates regarding a new wellness program in Hillman schools and the addition of a nurse and social worker. Girard also noted that the DHD4 concluded an educational program in schools for sixth through 12th graders regarding vaping. The DHD4 will begin a new educational program in schools for mental health.

— Devin Askwig, DHD4 community health director and epidemiologist, explained new initiatives of the DHD4 to provide “lock bags” to medical marijuana users instead of “lock boxes.” Devin explained that patients prefer lock bags as they are more convenient and discreet.

— Elisa Dack, DHD4 community and oral health director, discussed updates to her oral health program and issues surrounding access to dental care in the DHD4 jurisdiction.

— Bryan noted DHD4 will receive $100,000 from the CDC in the second week of June.