Top official explains proposed change for Health Dept.

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By Paul Delamar III

Editor’s note: Mr. Delamar serves as chairman of the Pamlico County Board of Commissioners. At the request of this newspaper, he has submitted the following opinion piece, explaining his position on a proposed change to the governance of the local Health Department.

BAYBORO – The Pamlico County Health Department has been the focus of recent attention from the public and the board of commissioners, most of it critical. As a county commissioner, it is my hope to provide some clarity to the situation, while addressing some concerns people have expressed to me about the department and our board’s goals.

First, the health department is currently governed by a board, whose members are appointed by the board of county commissioners. At present, the board of commissioners has only two roles: to set the department’s budget and to appoint its board. However, North Carolina law does not mandate this structure. Boards of county commissioners may serve as boards of health, directly overseeing the department, while maintaining an advisory board of professionals from different medical disciplines.


That raises two questions, both of which I will attempt to answer. First, why would we want to change that structure, giving the elected board more authority? Second, what is my (or our board’s) vision for this department? Both are fair questions.

Our board has struggled for more than a year with issues related to the management of the health department. As a commissioner, I have received more calls—nearly all of them complaints—about the activities of the health department than any other since I began serving on the board of commissioners in January, 2006.

The vast majority of these relate to the department’s responsiveness to the citizens it serves. Over the past year, several others on the board of commissioners have had the same experience, and none of us has the legal authorization to do anything about these complaints, beyond scrutinizing the department’s budget.

As a board, we have communicated these concerns with the director. As best I can tell, these concerns have been addressed either sparingly or not at all. For our county to grow and prosper, the people who pay the bills must know that they have a voice in their government. For us to give them that voice requires a change in the method by which the department is managed.

As to my vision, for the health department, I would first like to say that the department has many knowledgeable employees, some with years of experience. Most of those employees make their homes here and know the people they serve. I believe that the primary issue is one of leadership, not of competence or intentions.

The health department can be an asset to Pamlico County, and for the county to achieve its potential, it must be. First, the public should always feel welcome in the department they pay for. The expectation should be that all those having anything to do with the department will work as hard as they can, within the law, to assist the citizens of Pamlico County. Every person who walks through the doors of any section of the health department should get our best effort to help them with whatever problem they face. We should have a department that seeks out solutions for the people we serve.

This seems incredibly straightforward and uncomplicated. That’s because it is. We owe it to people to provide services in a timely manner as well. When people make application for services, they should receive constant communication and prompt service until their matter is completed. They should know from the outset that their problems are our problems and that we will not rest until they are solved, the same as we would if our own life, health or property were at stake.

Finally, my vision is to have a department that is highly trained and competent. Our employees should be trained to the fullest extent possible in every discipline their jobs might require. This includes keeping up with new regulations or procedures, to ensure the public gets the benefit of employees who have up-to-date skills. We should be able to help people right here in Pamlico County, without the necessity to communicate every decision to the state health department or the Attorney General.

If we do all these things well, our health department can become an asset to the growth and development of the county and a bigger help to those who are already here and need its services.

As important as what our health department should be doing is what our board generally believes it should not. The health department should not compete more than it already does with services offered by private providers, particularly where those providers accept insurance, Medicaid and private pay on a sliding scale. Pamlico County is fortunate to have more medical providers now than it has at any time in recent memory.

My vision is to focus on the services we already provide and to make the department more directly responsive to those who pay for them. By doing that, I believe the health department can become stronger, which will benefit the citizens and taxpayers of Pamlico County.