ERIK SANZENBACH / L’Observateur / August 9, 2000

EDGARD – The Louisiana State Department of Health and Hospitals will start shutting down 25 public health units throughout Louisiana in November. Oneof those units is in Edgard on the west bank of St. John the Baptist Parish.”As a west-banker I know this will be hard on everybody,” said a health worker who wished to remain anonymous. “I don’t know where they will gonow.”The closings are being done to offset a declining budget in the DHH. Underorders from Gov. Mike Foster, the department is trying to streamline itsorganization and make itself more cost-effective.

The health units are run by the Office of Public Health, and according to Assistant Secretary of Public Health Madeline McAndrew, public health took a big cut in its budget.

“We had $3 million cut out of our budget,” said McAndrew, “because the federal government reduced its funds to us by about $7 million.”McAndrew said that for every 25 cents spent by the state on public health, the federal government pays 75 cents. However, with the budget axe fallingon both the state and federal funds, the cuts to the public health units add up to about $13 million.

By law, the public health units are funded by both the parish and the state.

The parish must furnish the building and pay for maintenance and utilities while the state pays for the nurses and medical supplies. In St. John Parish amillage also helps to pay for some other parish employees.

According to Jeff Clement, chief financial officer for the parish, St. Johnpays about $92,000 in salaries to a sanitarian who works in Reserve, a case worker in Reserve and a clerk who moves between Reserve and the Edgard units. The parish also pays DHH $70,000 for personal and environmentalhealth services, and those funds are matched by the state and go to paying for nurses, medical supplies and other expenses.

The decision on which clinics to close were determined by several factors the DHH deemed important, including population of the parish, size of the parish, the age of the clinic, the usage of the clinic, the percentage of poverty and parish contributions to the clinic.

According to McAndrew, the Edgard clinic didn’t really have that many visitors in the past year.

“We looked at patients visits,” said McAndrew, “and there were 747 visits to the Edgard clinic in a year.”For the DHH, that isn’t enough to warrant the added expense of keeping the Edgard clinic open.

Also, due to personnel and money, the clinic in Edgard is open just two days a week, Tuesday and Friday, and a nurse from the Reserve clinic is on duty those two days.

Secretary of DHH, David Hood said, “It is unfortunate that we are having to consolidate some public health units, but we will still have at least one full- time clinic in each and every parish.”The citizens of St. John Parish will still have the Reserve clinic, but for someon the west bank that is of little solace. Because of the distance some west-bankers will have a long way to go.

“There is a lot of poverty over here, ” said the unidentified health worker, “and there are no other doctors’ facilities around. People are very upset.”However, McAndrew said they are consolidating clinics and people who cannot make it to Reserve can go to the St. James Parish unit in Vacherie, which is15 miles away.

“It is quicker to go across the river,” said McAndrew. The Reserve clinic isonly a few blocks from the ferry landing at Central Avenue.

McAndrew was quick to point out that the public health units are not primary care facilities. People still have to go to hospitals and emergency rooms toget medical care. Public health units are mainly for preventative medicine.”They provide immunizations, limited family-planning and pre-natal care,” said McAndrew.

McAndrew said St. John residents can still go to Lutcher and get primarymedical care at the hospital there. Also, there are several family clinics inSt. John on the east bank that will provide primary medical care like theMontegut Family Clinic.

Sean Roussel of the River Parishes Hospital doesn’t see any big change because of the unit closing in Edgard.

“Other than emergencies, we’re not expecting any big wave of people,” said Roussel. “We won’t see any big difference.”St. John Parish President Nickie Monica isn’t very happy about the decision atall.

“I received the news cold,” said Monica. “I had no idea they were going to closethe unit down.”Monica doesn’t have a lot of faith in the state’s plans for people on the west bank.

“The state doesn’t really have a plan at all,” said Monica. “They don’t have atime frame for this, and they haven’t figured out transportation for people over to Vacherie.”Councilman-at-large Cleveland Farlough met with DHH representatives and Monica Monday in what he described as a “preliminary meeting.” Farlough saidanother larger meeting with west bank residents is planned in the near future.

“What upsets me is how it happened all of a sudden,” said Farlough. “Theyhaven’t given us any options. This was suddenly thrust upon us. I don’t likethis haphazard way of doing things.”Farlough added, “I’m going to do everything in my power to keep the health unit open.”DHH officials told Monica and Farlough that since the parish owns the building and employs some of the staff, the parish could transform the health unit into a referral service. They even suggested that parish officials gettogether with the local hospital and see if they could make a satellite office for the west bank.

McAndrew said the Office of Public Health is trying to offset any difficulties that will be caused by the closings. She said Baton Rouge realized that a lotof people who go to the public health units will need more time to get there.

“That is why we will expand the operating hours in all of our clinics,” said McAndrew.

All clinics will now be open 10 hours a day, Monday through Friday, and a half- day on Saturday.

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