Executive Summary of Services Provided by Local Public Health Departments in North Dakota

August 1997
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North Dakota's public health system is made up of 28 single and multi-county local public health units (LPHUs).  The administrator of each health department responded to an August 1997 survey of services conducted by the North Dakota Department of Health.

It is important to note that services not provided by a local public health department may be provided by other agencies within the public health region.

One commonly held belief prior to this survey was that the only service provided by all local public health departments in the state was immunizations. According to the survey, however, services provided statewide include:

• Blood pressure screening (adults and school-age children)
• Scoliosis screening (school-age children)
• Vision screening (school-age children)
• Immunizations (all ages)
• High-risk infant follow-up
• Vitamin B₁₂ injections (treatment for pernicious anemia)

The following report provides a brief overview of survey results, listed by category of service. The most commonly reported programs and activities are highlighted.

Traditionally a high priority of local public health departments, many maternal and child health (MCH) programs are available in a majority of health departments. Primary prevention services available in 19 or more health departments include:

• Home visits
• High-risk infant follow-up
• Preschool conferences
• Sudden Infant Death Syndrome (SIDS) follow-up visits
• Child health services (general child health services not included in a specific program)

Health promotion and education programs provided by local public health departments include a wide variety of health and wellness activities. For many years, emphasis was placed on the provision of services to senior citizens, but the current trend is toward providing population-based services and education. Twenty or more departments provide the following services:

• Blood pressure screening
• Vitamin B₁₂ injections
• Diabetes
• Vision screening
• Foot care
• Community wellness programs

Historically, much of the emphasis of public health has been on prevention and treatment of communicable diseases. This function continues to be an important part of public health. Communicable disease programs reported by 21 or more local public health departments include:

• Tuberculosis
• Immunizations
• Skin and scalp conditions (such as impetigo or head lice)

Public health nurses have served as a resource for schools in North Dakota for many years. Their role has been, and continues to be, primarily health screening and education with limited provision of nursing services, such as administering medication or treatments. Nineteen or more local public health departments offer the following services:

• Vision screening
• Hearing screening
• Scoliosis screening
• Blood pressure monitoring
• AIDS education activities

The current occupational health nurse program is based on two federal grants. The first project involves surveillance of agriculture-related childhood injuries and illnesses at four hospitals in the Red River Valley. It also includes surveillance of agriculture-related injuries and illnesses among migrant workers at four community-based migrant health clinics in the Red River Valley. The second project provides a classroom-based agricultural safety program for fifth-graders, as well as a tractor safety certification course.

The majority of environmental health programs in the state are administered by the North Dakota Department of Health’s Environmental Health Section. Some activities, such as FFA and VA water and sewer loan inspections, are separate local programs. For the most part, however, local public health departments partner with state programs to provide environmental services. Program involvement most frequently reported by local public health departments include:

• Public water system inspection
• Water pollution control
• Environmental sanitation services
• Pool and spa inspection
• Private sewer inspection

 Mental Health

Most public mental health services are provided through the North Dakota Department of Human Services. Four types of services, however, are provided by local public health departments. The emphasis is on programs that provide spousal and child abuse prevention and intervention; 16 health departments offer these services.

In the past, many local public health departments were certified home health agencies, allowing for reimbursement of services by third-party payers; only four health departments currently maintain this certification. This change can best be explained as a movement away from the delivery of services that compete with the private sector and a movement toward expansion of population-based services. Twenty-three local public health departments now provide non-certified home visits, such as working with families after the birth of a child.

For several years, the Maternal and Child Health Division (MCH) of the North Dakota Department of Health provided special initiative funding to local public health departments for development of programs that address injury prevention, nutrition and oral/dental health. Most local public health departments participated in these MCH initiative grants until funding was no longer available. Since June 30, 1997, these services have been incorporated into other MCH public health programs.

Copyright © 2005 North Dakota Department of Health

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