Discussion on the usage of the prospective grants and overall affects on the programs in Butler County

The approval of the grant application to the Kansas Department of Health and Environment by the Butler County Health Department for the ongoing categorical grants caused a stirring of controversy at the Butler County Commission on Tuesday morning.

Health Department Director Janice Powers brought information before the commission to explain the usage of the prospective grants and its overall affects on the programs in Butler County.

“This series of grants will go to support five programs in Butler County,” began Powers. “In several of these programs, the staff involved are paid directly by them.”

She went on to explain the first grant, the Child Care Licensing grant for the amount of $72,308, will fund the salaries of the two part-time surveyors of various home and center daycares in the county.

“We have 104 daycare facilities in the county,” explained Powers. “Those facilities hold the capacity to care for 2,364 children. There are also three new pending licenses in the county. This grant directly funds the salaries of our part-time surveyors that are in charge of inspecting those facilities.”

“Are those inspections announced or do the inspectors just show up?” asked Commissioner Mike Wheeler.

“All of our inspections are unannounced,” said Powers. “They just show up at a facility for the inspection. If a facility is found to not be in compliance with any certain criteria, they are given the opportunity to come into compliance before a re-inspection will take place.”

The criteria of the inspections, whether too harsh or too lenient then came into question.

“Are all of these regulations reasonable?” asked Commissioner Peggy Palmer. “When you go into a facility, do you often hear that the regulations are not justified?”

“Personally speaking,” said Powers, “all of our regulations are justified and reasonable. There have been some tragic accidents in daycares and homes in this country and those regulations are there to prevent tragedy from happening.”

Child Care Facility Surveyor Jamie Downs stood to share a little more information on the procedures of child care regulations.

“By state law, a person can care for up to two unrelated children without having to be licensed for 20 hours per week,” said Downs. “The state considers most immediate family relations, such as children, grandchildren, first cousins. When you start branching into second cousins, that is when there are limitations to the time allowed to watch children in a home daycare setting. Those restrictions are also based on the ages of the children. Home daycare providers are only allowed so many children under the age of 18 months, preschool aged and school aged.”

“How many children are allowed to be placed in these homes?” questioned Palmer.

“With the proper childcare license, a home daycare facility may have up to 10 children,” said Downs. “A group home daycare may have 12 if there are two adults present.”

When the regulations for childcare centers were questioned, Downs went on to explain daycare centers base the number of children allowed on the amount of space available. Some daycare centers are licensed to care for 20 children and others are licensed to care for 120 children.

In regards to whether the regulations for daycare facilities are reasonable, Downs went on to explain her experience.

“In my 21 years of experience in this department, I have only had five suspensions or revocations of licenses,” said Downs. “We give them time to fix anything that was not up to regulations and re-inspect them.”

“We really do support helping people try to resolve their problems,” said Powers. “We are aware that we need these facilities in our county.”

The second potential grant was for the amount of $43,257 for the Chronic Disease Risk Reduction (CDRR). The grant’s main focus is to improve the overall health and nutrition of the communities in the county.

“Our health educators have done wonderful things with this program in the past,” said Powers. “This year, the potential projects are: a community garden in Augusta and a year-round farmer’s market in El Dorado. These are a means of increasing the consumption of fresh fruits and vegetables in the communities and an effort to make healthy eating more affordable.”

The grant will not feed directly to the project, but instead it will help to fund the committees in charge of working on the various projects.

“The grant will be used to pay the salary of the Health Educator and increase that position from part time to full time,” Powers said. “It will also be used as a support of the health committee.”

She went on to explain the health committee is a group of individuals from the communities affected. They are a grass roots organization that gathers a list of prospective projects. The grant in the past has funded the fun run and Kansas Kid’s Day. A portion of the grant must be used toward tobacco use.

One goal of the committee with this funding is to allow the farmer’s market in El Dorado to accept food stamps, but some commissioners began to show concerns about the focus of the committee.

“I imagine right now at the farmer’s market the vendors collect sales tax,” began Commissioner Ed Myers. “I’m just wondering is this something we should be concerned about. Is it reasonable for the farmers to be set up to take food stamps? What will it take to get them to that point?”

“The Andover’s farmers market is set up to take Vision food stamps,” said Downs. “It has been set up for years. At this time Andover is the only one that is electronic benefit transfer (EBT) accessible.”

“The system no longer uses paper food stamps,” explained Powers. “The benefits are set up on a Vision card.”

“If you can process credit or debit, you can process Vision now,” said Commissioner Jeff Masterson.

Myers and Palmer still did not seem satisfied with the choice of the funded programs.

“Do you think there is a duplication of programs here in Butler County?” asked Myers. “There’s 12 Baskets and Numana. Will the use of food stamps at the farmer’s market hurt those programs?”

“First off, the garden that is being suggested will be placed in Augusta,” said Powers. “The Numana garden is in El Dorado. In my opinion, supporting a local farmers market would not impede on a program because the market provides other things besides produce. Those two things are just two of the four objects focused on by this committee with this grant. The other projects focus on tobacco prevention.”

“When you talk about the project in Augusta,” said Palmer, “the plan is to open a community garden. What kind of garden is in the plans and who have they contacted? How do you know if this really necessary?”

“Our Community Help Needs Assessment tool has suggested that the access to fresh fruits and vegetables was limited in the area,” explained Powers. “A similar project has been very successful here with the Numana garden. Over the course of the next year the committee will explore how to make that happen. They’re already talking to the City of Augusta to find some unused space.”

When asked about the personnel’s contributions to the committee, Powers explained the health educator is not there to make the decision on what the group focuses. She is there to support the committee by creating agendas, doing research and ensuring the group meets regularly.

Palmer began to express some concern on the effectiveness of the committee’s actions.

“I’ve seen these types of groups with these same goals before,” said Palmer. “The project never begins. I want to see the outcomes of the plans for this group so we can make sure they follow through.”

“If we do receive the grant funding, we will be able to pay our health educator to work more than part-time, which is only 20 hours per week,” explained Powers. “She is only allowed to work for four hours a day to accomplish this. She can do even more if she is taken to full time. If this program goes away, so does the position. She has found motivation to make sure that she is hitting those objectives. In order to be re-funded for this grant, the committee has to be able to show action and movement with these projects.”

“What kind of incentives are you giving to the committee members to get this done?” questioned Palmer.

“We do not give the members of this committee any kind of incentives as far as financial means,” Powers said. “The main incentive is the want for a better, healthier community. We have a high rate of obesity in Butler County. If you start young and help people learn how to make healthy decisions, they can make positive choices for themselves later in life.”

“These programs have been in place for a long time and they have not been successful in the past,” said Palmer. “I think the state would look at it better if it was funded at part time.”

“The final contract comes here for the commission to approve,” said Powers. “If they think the health educator working full time at this point is not good, they will not approve that part of the grant and they’ll send it back. I know a lot about this funding and I’m passionate about it. I was with this program when I started at the state. They won’t fund stuff. Billboards don’t make a different, neither do brochures. They fund activities. They give us free stuff to hand out so we can talk to community members. That is how we make the most difference.”

The commission then moved their focus to the Family Planning grant application for the amount of $67,775.86.

“I have an issue with the medication Depo Privera that is packaged with this set of grants,” began Myers. “It says here, the medication is a mechanism of action that prevents pregnancy and results in endometrial thinning. Contraception today means anything that prevents implementation. Fertilization for me is actually when life starts. I take that paragraph to mean that life has already begun and can be ended. “

“I understand your concerns, the federal government has put together the family planning grant,” explained Powers. “There is a stipulation that states which states no federal dollars could fund abortion. They specifically say that we should have an injectable birth control option. What this medication does is it stops the egg from being released by the ovary. It thickens the mucus membranes from reaching the cell. It also thins the lining so the egg cannot implant into the lining of the uterus. Cell division does not begin until it does implant. I would be horrified if I was giving a woman anything that would cause her to lose her baby. There is no guarantees for all pregnancies to serve to the end. Ten to 20 percent of pregnancies end in miscarriage naturally. Every contraceptive has a risk. It’s our job to keep those members of the communities informed.”

“How much do you use this injectable in your office?” asked Palmer

“Out of 438 women that we saw, 138 are the one-month hormonal injection,” said Powers. “And 173 do a three-month injection. A majority of our women are on Depo. It is exactly like a pill that does not have to be taken at a precise time every day in order to be effective. While they are in our office, we give them information about all contraceptives. If they are not a good candidate for Depo we provide them with information on other contraceptives. There is a time limit that they can actually use this drug because it can cause a loss of bone density. Once they hit three to four years they will move toward the pill.”

The commission then began to show concerns on who was paying for the contraceptives.

“There is a sliding fee scale,” explained Powers. “Women pay for a portion of it. What they cannot pay for is paid for out of the grant funds. Even the people who are 100 percent below the poverty level, we encourage them to pay something toward the medication in order to put something back into the program. We don’t turn anybody away based on their ability to pay.”

Powers went on to explain in-office contraceptives are not the only aspect of the program. The health department also visits the community college once a week in order to offer screenings and information to the students away from home.

“We have seen 1178 students with these weekly visits,” she said. “We performed 189 pap tests and 240 breast exams. If we find anything, we refer them to a physician to help them receive the care they need. This is important because those students might not be seeing a regular physician otherwise. This program is more than just birth control.”

The final grant considered for approval was the Maternal and Child Health grant in the amount of $59,670.

“The purpose of this grant is to ensure pregnant women receive prenatal care,” said Powers. “If they don’t have insurance or the means to receive medical care, we do have funding to provide prenatal care for them.”

Masterson then moved to approve the series of grants, totaling $288,187.86 for the Butler County Health Department. The motion was carried 3-2 with Myers and Palmer opposing.

The commission also:

• approved the award of a bid for a mowing tractor from SCAAB International for the amount of $138,852.42 for the Public Works Department.

• approved the award of a bid for a rotary mower from Wichita Tractor Company for the amount of $60,174 for the Public Works Department.

Kari Adams can be reached at kadams@butlercountytimesgazette.com.