10/22/09 — Board of Health re-evaluates 4-day work week

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Board of Health re-evaluates 4-day work week

By Phyllis Moore
Published in News on October 22, 2009 1:46 PM

The four-day workweek as it relates to Health Department services might need revamping, the Board of Health conceded Wednesday.

The abbreviated hours of operation came under fire on several levels at the board's monthly meeting, not the least of which was having the department recognized for what it is -- a health care facility.

More than a year ago, in August 2008, county offices adopted the four-day workweek as a cost savings measure. The recent state budget crisis only compounded the problem.

"The key consideration is cost savings with electricity because we're under a budget crisis right now," said James Roosen, health director. "Of course, we did get permission to be open on (Friday) the 23rd for a flu clinic."

Board Chairman Ira Thigpen said the Health Department should be categorized differently than other county offices.

He suggested the county manager "needs to be able to handle this as a medical facility and not like the landfill. That's the problem that I have run into ever since I have been on this board. This is a medical facility. It's got to run like one."

Board member Steve Smith agreed.

"It's a great idea to close facilities when they're not needed, to save money whenever you can," he said. "However, I think in this case, Wayne County is being underserved because this building is being used as a multi-purpose building."

He suggested a way be found to have the building dedicated to health care and let it serve as such.

"If the building falls under the county guideline and needs to be closed because of budget constraints, that's all well and good," he said, hinting that one possible short-term solution be to make an exception for the Health Department.

The issue was fueled by a request from Dr. Joseph Flynn, representing Goldsboro OB/GYN and Wayne Women's Clinic. Flynn raised questions about the upcoming Christmas holidays, when the Health Department will be closed for 10 days.

Having "no OB service for 10 days" poses a concern for patients, particularly high-risk women requiring twice-weekly monitoring, Flynn explained.

"In addition, for those 10 days, those patients are without a health care provider," unless they go to the hospital, he added. "Both of our practices feel if the Health Department is closed for those 10 days in a row, it will be leaving patients exposed."

The Christmas closure were not determined internally, said Ken Stern, administrative officer.

"(The county) made the decision to rearrange those holidays," he said, explaining that the shift, incorporated with the four-day workweek, resulted in an extended Christmas break for the staff. "It's not vacation days, it's not voluntary days off, it's mandated as time off for the county."

Thigpen said efforts will be made to have more office hours during the holiday period.

"I'm sorry that happened, and we're going to try to remedy it," he said. "It's nobody in this building's fault. It's unfortunately money telling this building what to do instead of a medical person deciding what's best and talking it over with the health director and coming up with an idea."

Thigpen said he hadn't realized earlier that the department would be closed a full 10 days, and added that he would look into the situation further.

"That's all we ask," Flynn said. "I don't think anybody here was trying to deprive health care for 10 days."

Board member Dr. Michael Gooden shared Flynn's concern.

"I'm very empathetic," the retired physician said. "In my days of practice, I would find this unacceptable. I would like to go on record (and) pass a resolution asking the health director and county manager to work together with the two OB groups. I think we can manage this issue of the Christmas holidays."

Thigpen recommended there be a liaison between the Health Department and county, and that in the future scheduling concerns be discussed early on, when the calendar is initially released.

Roosen said he would favor "having a meeting of the minds."

"We have had discussions. Obstetricians and I met with the county manager," he said. "Lee Smith is well aware of the situation."

He said he has also had discussions with Lee Smith and Sue Guy, county human services director, about the services being offered by the Health Department.

"We see 44 percent of the prenatal patients in this county," Roosen said. "That's about 800 patients a year that come through the Health Department for prenatal care."

Likewise, obstetricians are also customers of the Health Department, he said.

"The bottom line is we're a medical provider," added Tommy Gibson, board member.

While a fair resolution to the issue is the aim, as it now stands an equitable situation for patients has not been found, Steve Smith said.

"It's more than OB," Roosen noted. "It's STD, family planning clinics. We have got lots of patients out there that depend on us as a medical provider. I will just leave it at that."

Smith pointed out that there are discrepancies with the county plan.

"If there was some way to come up with, that the Health Department doesn't fall under that category" justifying the four-day workweek, he said. "The Sheriff's department doesn't fall under that category, the jail doesn't close for the holidays."

"Just as there's an office in the courthouse that stays open for real estate transactions on Fridays, I would love if you would have the same type of exemption," Flynn said.

Board member Dr. Sandra McCullen, who is also a county commissioner, said the matter is "always open for reconsideration. That can be discussed."

Gooden said he would welcome a presentation on just how much money has been saved by mandating a four-day workweek.

"I would like for us to request a meeting with the county manager or his representative to show us what savings we have had in closing the Health Department and for them to consider continuing to have health care five days a week," he said. "That's a motion -- for the county manager to reconsider the wisdom of closing the Health Department."

Thigpen said he had invited Ms. Guy to attend a future meeting.

"Unfortunately, we're at a disadvantage, and I don't mean anything bad by it," he said. "I just know how things work.

"You can have numbers reflect a lot of different things. Because it was a certain person's idea (to adopt the four-day workweek), you can make the numbers say anything you want. I just hope that they'll look at the whole picture and see what we see."

Gooden reiterated Smith's comparison to other departments in the county.

"The Sheriff's department doesn't close on Friday," he said. "The Health Department is an essential service for the county and doesn't fall into the same (category) as the trash recycling."