State health director weighs in on Alamance County case

August 22, 2008 - 5:25PM
Robert Boyer / Times-News
Recent developments at the Alamance County Health Department are hurting the agency's primary mission to protect the public health, says Leah Devlin, North Carolina's health director.

"The recent events in Alamance County, where health department medical staff were put on administrative leave and health department medical records were searched (albeit under the required court order) in an attempt to identify undocumented persons being served, undermines the ability of the local health department to protect the community from serious health problems," Devlin wrote in an Op-Ed piece that recently ran on the state Department of Health and Human Services Web site. "The public's health stands at risk whenever critical public health services are not universally and widely available to protect the entire community."

At least in the short term, Hispanic patients don't seem to be shying away from seeking treatment, said Alamance County Health Director Barry Bass. Statistics over the past several months show a rise in overall visits.

For more than two months, the county health department has been mired in controversy over two staffers' occasional writing of alias work notes for Hispanic clients. Concerns about the work notes led the health board to make changes in policy, and resulted in an investigation involving the SBI, the county sheriff's office and an investigator with the federal Department of Health and Human Services.

Investigators found no wrongdoing and no evidence of deception by any health department employees. A federal and local district attorney agreed and declined to file charges.

Health board member and county Commissioner Bill Lashley has said, based on a conversation with an SBI agent, he thinks investigators are covering up the use of local funds for Medicaid, but has so far produced no evidence.

The staffers, Medical Director Kathleen Shapley-Quinn and Nurse Practitioner Karen Saxer remain suspended with pay. County Health Director Barry Bass has said he will decide by Sept. 8 whether to reinstate Shapley-Quinn and Saxer.

The board is now considering a policy covering alias work notes that, among other things, limits work notes to one alias and requires a client requesting the use of an alias name to fill out a personal data continuation sheet, which is placed in the client's medical file.

In her Op-Ed, Devlin took aim at anything that hinders patient access.

Policies regarding undocumented immigrants could scare them away from seeking care and increase the threats posed by communicable diseases, fewer immunizations and a lack of prenatal care, Devlin said.

"The health of the community can only be protected if every person, regardless of his or her legal status, receives the necessary health interventions," she wrote. "Access to and confidence in the public health system that protects everyone, is a separate and unrelated issue from the legal concerns related to undocumented persons. The federal government understands this - it is illegal to accept federal funds and deny essential public health services to anyone, including undocumented persons."

She continued: "It is absolutely critical that local and state governments likewise continue to assure - as they always have - that no barriers are raised to accessing essential public health services that protect health for all the people in our communities."

At Tuesday's county health board meeting, Chairman Keith Whited agreed with Dennis Harrington, the deputy director of the state Division of Public Health, who said county health departments must provide care to anyone, regardless of any name they give.


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