Scott D. Lenhart, former Pamlico County Health Director: “Goodbye Pamlico County! Fair Winds and Following Seas”

Scott D. Lenhart

First, I want to say thank you to all the citizens and the former Pamlico County Health Department Board Members who supported me and believed in me.  These Board Members are Dr. Jason Rose, Dr. Joshua Rose, Lori Altman, Starr Murphy, Cliff Braly, Dr. Deborah Parish and Ed Riggs, Jr. for their support during the first two years.  In addition, several community leaders I would like to thank for their support of the health department programs and vision along with our working relationships we have built during my tenure as the County Health Director.  These are Lisa Jackson, Pamlico County School Superintendent; Dr. Jim Ross, President of Pamlico Community College; Chris Watson, Arapahoe Charter Schools; Susan Bridgman, Director of Pamlico County Partnership for Children; and, Debbie Green, Director of Pamlico County Department of Social Services.  

Also, a special thank you must go out to Dr. Diana Silimperi and her COVID Community Taskforce; Yolanda Cristiani, Director of HOPE Clinic, and Dr. Roger and Sandy Merrill for their vision and support of the Opioid Treatment Program.   Also, a big thank you to the Pamlico County Health Advisory Board members who supported and advocated for the health department during this time.  Last and the most important are the staff of Pamlico County Health Department for their support, dedication, and hard work during these unknown times of public health. With a limited staff and resources, the staff made it work and was there for the community when needed.  

As many citizens of Pamlico County may or may not know, I have made an exceedingly difficult decision to retire from Public Service.  After 43-plus years, I have seen and accomplished what I consider many victories for the citizens and populations, which I had the great privilege of serving.  Out of the 43 years of service, 21 years were with North Carolina Public Health and 4½ years were with Pamlico County.   

 It has saddened me that I have heard several rumors of why I decided to retire. Believe what you want to believe, but I can tell you what was stated in my resignation letter: “This decision does not come lightly; however, the decision to retire was based on a number of factors.” And, yes, one of these factors was the health of my wife, but it was not the only factor. 

One rumor in particular I want to put to rest with this letter. The Pamlico County Community COVID Taskforce had nothing to do with my decision to retire from public health.  The county should be honored to have these individuals and their expertise to assist our understaffed and underfunded health department during the COVID Crisis.  These individuals did an outstanding job and did tremendous amount of work getting needed information out to the community during the COVID Pandemic, which the health department should have been doing during this time.  In addition, they also volunteered with vaccinations, appointments, administrative duties, and many other activities not seen by the public. I value their dedication and partnership during this time.  

 I came to Pamlico County in late November 2016. It was Thanksgiving week when I started.  I came here with high expectations of a county wanting to fix its health department, bringing back programs and services that were once here.  The Pamlico County Board of Health, which hired me in September 2016,  gave me three mandates to work on the first year:  (1) Improve the image of the health department.

(2) Increase programs/services within the health department and bring back patients. (3) Improve and fix environmental health.

My staff and I did exactly what was mandated.  Some say I did to good of a job during the first year. 

Many individuals will think what they want to think and pass judgment on our health department, on the staff and myself, not knowing the facts.  Many questioned my abilities and authority during my tenure.  One fact that I do know for sure. Many individuals did not even know what public health is,  who I was, and what qualified me to be hired as your county health director.   If interested, the newspaper’s online posting of this article will have a link to my resume. Judge for yourself. 

As for the future of the Pamlico County Health Department, this remains to be seen.  Several individuals in this county believe we do not need a health department providing services. They have suggested the county has two other health agencies, which should handle these services.  What services?  Not public health services!  There is more to public health than seeing sick people. 

Who handles the community outreach, community health assessments, and health education and prevention for the community the health departments are mandated to do?  What agency actively works on prevention within the community?  Who will handle the Ten Essential Public Health Core Competencies?  See the attached website for more information:  CDC – 10 Essential Public Health Services – CSTLTS.  These are all part of public health.  No other agency in the county can provide these services without having dedicated and committed partners and support.  

Many times, it was said the health department was in competition with these other agencies for patients. This statement makes no sense whatsoever.  If true,  then all county health departments in North Carolina are doing it wrong!  Also, why does the county have more than one gas station, grocery store, pharmacist, law offices, auto repair/supply businesses, restaurants and many more businesses?  Should we tell business to not come because they are in competition with others?  

Let us look at one service I was given permission to restart –The Child Health Program. Our health department was seeing 10% of the pediatric population.  Also, compensation for the pediatrician we recruited was reimbursed from state-paid funds, and from insurance and Medicaid.  We were on track to generate an influx of revenue into the health department budget.  There were no county funds used to pay for the services of our pediatrician.  Some county funds were used to pay for staff services, but these would have been there regardless – whether we had the program or not. 

So how is 10% of the population in competition with other providers, when one provider does not see pediatric patients?   Another question, why take away a service and make it harder for the community?  It makes better sense to add services to help close the gap! These other healthcare agencies run under a different business model in seeing patients.  They have their own patients, which will fit into their business model and public health will have their patients.  In many small rural counties throughout North Carolina,  Public Health Departments are the Safety Net for a community lacking health care providers.   

What agency took the lead in investigating and tracking all positive COVID cases and contacts in our County? What agency helps individuals seek testing and treatment for breast and cervical cancer for individuals who do not have the means or the insurance? What agency provides nutritional supplements for pregnant women and children? What agency is responsible for tracking and ensuring children of school age are current with immunizations?  Who tracks and investigates all reportable community diseases?  What agency tracks children under the age of 5 in their physical and mental development and assists the families in getting needed services when a problem is discovered?  What agencies in NC provides one of the best prenatal care available to pregnant women?   Answer to all these questions is Public Health and we do a lot more!    

As a citizen who pays taxes, you need to start asking questions. Where do my tax dollars go to help pay for public health?  The North Carolina General Statues 130A on public health states the counties must either provide or assure public health services are offered to our citizens.  If public health is scaled back and we do not have public health and a Safety Net for Individuals, will these other agencies in the county be willing to do public health duties and programs?  How can the county assure these individuals are being treated and are being seen by others, if we do not have a public health system in place to provide services?  Funding, Staff, Health Programs, and partnerships are all needed within the Health Department to achieve accreditation by NC Public Health.

Our health department is currently not accredited.  We have been trying to achieve accreditation for years but without the proper support, staff, programs, partnerships, and funding it is extremely difficult to reach 140-plus “benchmarks” to get accredited.  Not to mention three hurricanes and the COVID Pandemic, which took lot of time away from our staff.  In North Carolina, small health departments are accredited, but we must step back and look at the differences and dynamics of these health departments compared to our own here in Pamlico County (past, present and future).  

I could go on. County officials must figure out what is best, and how to run the health department.  They need to do what is morally and ethically right for the citizens of Pamlico County.  I challenge all citizens of the Pamlico County to step up and ask these difficult questions and get involved.  May God Bless you all.