Taking a tour of the Jackson County Health Department on Tuesday afternoon, Dr. Kristina Box was impressed with what she heard.
One of the first things the Indiana health commissioner learned about was the Collaborative Advocacy Referral & Educational Services Clinic, which is a part of the department’s harm reduction program that provides screenings for HIV and hepatitis C and distributes the opioid overdose reversal drug naloxone to those who need it.
“The harm reduction program CARES is a great outreach for individuals struggling with substance use disorder and a start to help decrease the spread of infection with HIV and hepatitis C,” Box said. “This can lead to more individuals getting into treatment programs and helps individuals caught in the throws of substance use disorder begin to believe that recovery is possible.”
Another thing that stood out to Box was the department’s high rate of 11- and 12-year-olds receiving the human papillomavirus vaccine. The 35 percent rate is one of the best in the state, she said.
“Their team has really taken this to heart and are dedicated to protecting children of today against the cancers and disease caused by the HPV,” she said.
“I was very impressed with the programs they have instituted and their dedication to the people of Jackson County,” she said.
Tuesday’s stop is a part of Box’s mission to visit every health department in the state to see what they are doing and listen to their concerns and suggestions.
Box was commissioned by Gov. Eric Holcomb on Sept. 18, 2017. She said she started the tour earlier this year and by the end of the week will have been to one-third of the health departments in the state.
There is one in each of the state’s 92 counties with Lake County being the only one with three health departments.
Box said the Indiana State Department of Health exists to serve the people of Indiana, promote good health and make sure services are available to residents across the state.
“Our local health departments are our boots on the ground,” she said. “They provide the services to the people in their community and are trusted by their community. They know what their community needs, and they work in collaboration with the local hospitals, elected officials and community-based organizations to provide needed programs and education to the residents of their community.”
She said the most important job of the state health department is to support the local health departments and serve as a resource to them.
“Therefore, it is important that I visit and get to know the people who work tirelessly in the local health departments and that they get to know me,” Box said.
Dr. Christopher Bunce, public health officer with the Jackson County Health Department, shared information about the CARES Clinic with Box.
He said the county may wind up doing a needle exchange, which provides injection drug users with clean needles, safe disposal of used needles and other resources and access to treatment services.
For now, though, the CARES Clinic operates from 5:30 to 7:30 p.m. Thursdays at the health department, 801 W. Second St., Seymour.
The clinic came to fruition from a grant the health department received from the Indiana Local Health Department Trust Account, formerly known as the Tobacco Grant. Jackson County Commissioners approved the hiring of Christy Thrasher as the clinic coordinator, and the clinic opened Feb. 22.
Bunce said the clinic is a steppingstone to getting a needle exchange, and he has met with county commissioners, police, the county prosecutor and ministers about the program.
“I’ve been trying to do this very methodically to try to get people used to the idea that what we’re actually trying to do is reduce the transmission of disease and that what we’re doing is not enabling anything but health,” Bunce told Box. “That’s what this CARES Clinic is all about, and Christy has done a fantastic job.”
Bunce said the state’s HIV and hepatitis division has been a big help.
“They reassured us that they like the way we’re approaching it,” he told Box.
He said neighboring Lawrence County started a needle exchange but then had to step back away from it.
“We don’t want to have to do that,” he said. “We want to be able to do it the right way and educate the community while we’re helping. That’s what CARES Clinic is all about.”
Naloxone distribution also is a service at the clinic. Through a grant, the health department has been providing it to anyone who walks in and requests it.
“If something happened tomorrow, we could start a needle exchange,” Bunce told Box. “It’s just we want to reassure our commissioners and everyone else that we’re doing the other things that they care about, as well.”
Box said she testified in Madison and Scott counties when their officials voted on needle exchanges.
“We approach it from the infection standpoint,” she said. “We know it helps prevent the spread of HIV and it helps prevent the spread of hepatitis C and it gives you the opportunity to vaccinate people for (hepatitis) B and A.”
Bunce also said promoting HPV vaccinations is one of the department’s priorities. HPV is the most common sexually transmitted infection with 79 million Americans, most in their late teens and early 20s, infected, according to the Centers for Disease Control and Prevention.
Lin Montgomery, public health coordinator/educator at the Jackson County Health Department, said HPV could cause significant consequences, including cervical, vaginal and vulvar cancers in females and anal cancer in males.
Vaccines can stop these health problems from happening.
“Fortunately, not everyone becomes infected. Unfortunately, we don’t know who might,” Montgomery said. “The other unfortunate fact is that there is a window of opportunity that is often missed when youth are receiving the recommended/required immunizations and their parents decline the HPV vaccine.”
Thus far on Box’s tour around the state, she said the biggest area for improvement she has heard consistently relates to the vital records division. She said the support and training for local health departments have fallen short.
To turn that around, she said local health departments will train with officials from the state’s vital records department, and those working in the state office will be available to answer questions in real time.
“(The) assistant commissioner over this division has been actively reaching out and meeting with the Indiana Vital Records Association to make sure that we are reorganizing to meet the needs of our vital records departments across the state,” Box said. “We are in the process of replacing our birth and death registries and will make sure that appropriate trainings occur as these are rolled out.”
Box said every time she meets with a local health department, she learns something new about the organization at the state level and about the programs in the state that are making a difference in residents’ health. She shares all of that with other departments.
“I love visiting all of the counties that make up this great state of Indiana and meeting my fellow Hoosiers in their home communities,” she said. “It makes me proud to be a Hoosier.”
[sc:pullout-title pullout-title=”Box file” ][sc:pullout-text-begin]
Dr. Kristina Box was named Indiana state health commissioner by Gov. Eric Holcomb on Sept. 18, 2017.
She was a practicing obstetrician and gynecologist in Indianapolis for 30 years, starting her career at Community Hospitals of Indianapolis in 1987 as a private practitioner with Clearvista Women’s Care.
Since 2015, she has served as the physician lead for Community Health Network’s Women’s Service Line. In this role, she built the first multidisciplinary women’s center in the Community Health Network, developed critical partnerships with area children’s hospitals to improve care and decrease health care costs and led efforts to ensure low-income women receive the important free health screenings they need.
She has served on the Indiana Perinatal Quality Improvement Collaborative, an advisory council to the Indiana State Department of Health that is comprised of more than 300 statewide community professionals working to reduce infant mortality. Her work includes serving on a state task force to address neonatal abstinence syndrome, which established standards for the diagnosis of NAS and developed a hospital study to determine the prevalence of drug-exposed newborns.
Box earned her undergraduate degree at Indiana University in Bloomington and her medical doctorate at Indiana University School of Medicine in Indianapolis. She is a member of several professional organizations, including the Indiana State Medical Association and Marion County Medical Association, and serves on many hospital committees.
She has been involved in ongoing surgical medical missions to Haiti and Bolivia for more than a decade.
She and her husband of 35 years, David, a retired ophthalmologist, live in Indianapolis. They have four adult children.
Source: in.gov/isdh/18940.htm
[sc:pullout-text-end]