“A lot of people think that Public Health is the clinic of last resort for people in need of health care. That isn’t the case,” said Mimi Hall, the agency’s director.
Hall appeared before the Board of Supervisors on Jan. 17 to explain what the agency does and does not do, the agency’s strategic plan and vision and the need for financial reserves if the economy suffers.
Hall said that the agency does provide immunizations, family planning and childhood services, and is currently piloting a new program that uses medications to wean people from opioid addiction.
These services can be found at the County Annex Building located at 270 County Hospital Road.
The agency’s primary function is to promote and protect community health and well-being in the broadest sense. This includes promoting a whole spectrum of preventive measures, as well as monitoring and suppressing communicable diseases.
One of the roles of the agency is to help coordinate health and well-being amongst a network of agencies and programs throughout the county and to funnel funding and support to those programs.
In general, the agency works with those organizations that positively affect the health and well-being of people where they live, work, play, shop and go to school.
“Our job is not to do the job. Our job is to be strategic, to look at all the resources available and to help coordinate all those resources, so as to provide the healthiest environment possible for our citizens,” said Hall.
Only about 1 percent, $66,000, of the $5.5 million Public Health Agency budget comes from the county’s general fund. Another 16 percent, $882,000, comes from California taxpayers; from a portion of vehicle license fees and state sales tax revenues.
The rest, 83 percent, comes directly or indirectly from the federal government.
The largest percentage, 61 percent, of this money goes to health education and disease prevention, 16 percent goes to nurses and clinics and 15 percent goes to senior nutrition and transportation. The remaining 8 percent goes toward emergency preparedness and veteran’s services.
In order to provide for the health and well-being of Plumas County in the most responsible way the staff has to know what they are trying to do and how to go about it.
Hall and her staff recently finished the first community health strategic plan developed for Plumas County. This strategic plan identifies priorities and then provides the road map on how to get there.
This plan will guide the staff’s decisions on a week-by-week basis for the next five years. “Every Monday we go in and update the plan to document what we have accomplished. I can see it and all our supervisors can see it.”
Hall said, “Our staff really believes in every bit of this strategic plan because they were involved in constructing it. We can see how we, together, are all working for the same things.”
Hall considers this plan “our gift for our community” to ensure that the county has the best healthcare possible for years to come, despite who is on the board of supervisors or who is working in the agency.
New county supervisor Michael Sanchez, whose background is in hospital management, praised Hall by saying: “Your strategic plan is very well written.”
The agency’s vision statement says, “Plumas County is home to the healthiest people in the nation, who have strong social connections and work together for a better community.”
Hall said, “We really believe in this and act on it. Health is more than that your body is OK.”
The agency works to attain this vision through constructing innovative relationships with its many partners and ensuring respectful service to those it collaborates with and serves, according to Hall.
Need for reserves
In 1991, the state enacted a major change in the relationship between state and local government, known as realignment.
In the areas of health, social services and mental health, realignment transferred programs from the state to county control and responsibility, altered program cost-sharing ratios, and provided counties with dedicated tax revenues from the state sales tax and vehicle license fees to pay for its programs.
Hall pointed out that no growth in realignment has occurred in the last three to five years.
“When the economy goes down, our revenues go down. Meanwhile, the need for our services goes up. This is a problem,” said Hall. “We are trying to build our reserves. We target these reserves to help our most vulnerable individuals and families during lean times.
Hall pointed out how a community spends its money tells you what that community thinks is important.
Hall added, “A full $4.4 million of our $5.5 million budget goes to staff salaries and direct services to clients.” Direct services include funding clinics, investigations, lab costs and payments to contracted doctors and other patient services organizations.
According to Hall, “A half million goes to the county to cover the overhead provided by the county.”
Hall concluded, “I’m excited by what’s happening in California, even though we have a lot of challenges. I’m excited to be part of this county.”
More on Plumas County Public Health Agency’s mission, goals & functions can be found at countyofplumas.com/publichealth/.
The Agency’s new strategic plan can be found at plumascounty.us/PHStrategicPlan.
Plumas County Public Health Agency programs
Investigation and control of communicable diseases
Emerging Diseases (Ebola, Zika, Panflu, etc.)
Hospital Emergency Preparedness
HIV medical care
Sexually transmitted diseases
Disease Vector Control
Alcohol and Drug Addiction
Births and Deaths
Reproductive Health Services
Emergency Medical Care
Clinical and Nursing Services
Health Insurance Programs
Nutrition and Access to Healthy Food
Toxic and Hazardous Waste
Sewage and Liquid Waste
Solid and Green Waste
Mimi Hall’s backgroud
Mimi Hall gave an account of what motivates her as Director of Plumas County Public Health Services.
I was born in Burma and my family came to the U.S. in the very early 1970s. I didn’t speak English when I started school. In Burma, most places we lived had no electricity or running water.
My parents were public health physicians. The clinics they worked in were usually cots in crude bamboo structures on dirt floors.
We lived in the medical compound with the other workers and it was a very communal kind of living. My parents served more people in our home after hours than in the clinics.
My dad lived and breathed the philosophy that every human being has certain rights, and one of those rights is to be treated with dignity. My mom traveled to remote villages in a donkey cart, working with the Red Cross to give vaccinations.
My parents were adamant they did not want to raise their children in a military dictatorship void of basic civil and human rights. My dad had pictures of JFK and MLK displayed in our sleeping area.
So, they gave up quite a bit to bring us here and used what savings they had to bribe officials for our visas and other paperwork. A hospital in New Jersey sponsored our family to come to the US and hired my dad as a lab tech.
After my father passed his US medical boards, he secured a residency at Cook County General Hospital in Chicago. Nobody would hire a foreign born physician in the Midwest in those days.
My dad worked multiple hourly wage jobs to support us until finally, a medical group hired him at half the compensation of any other physician in the practice, taking twice as many on call days.
He was grateful for the work, but the inequities were a source of contention between my parents, and even as a child, I understood an inherent injustice, though I couldn’t articulate it.
My experience growing up in a rural, Midwest community and my brothers and I being the only people of color in our school were valuable in informing the work I do today.
Additionally, our roots in Burma and my admiration for the way my father lived his life, treated others, especially those most vulnerable, shaped my interest and passion to pursue a lifetime of work in public health.
Hall moved to Quincy in 1999, having never been there before, and married her boyfriend, a native of Quincy. She began working at the Public Health Agency and then had the first of three children and took some time off work.
As a stay at home mom, Hall was frustrated by the difficulties she encountered in enrolling in certain social programs, particularly to get health care coverage.
Hall returned to work at the Agency in 2005 because an insurance company dropped her and one child because of a pre-existing condition.
This experience was just one of many that helped to inform her work over the past few years: which has been to simplify and streamline people’s access to services.
Hall said, “Overall, I feel so fortunate to be able to work in a community where four generations of my husband’s family live and where we are all so interconnected. This personal connection helps me really realize that the goal of our work is to improve population health in Plumas County.”
Hall graduated in the arts, liberal arts, and sciences at the University of Illinois. She followed that up by earning another major in bioscience at the University of Hawaii at Manoa.
After being certified as a health education specialist, she went on to obtain a master’s degree in public health at the same university.
More recently, Hall attended the Sierra Health Foundation Health Leadership Program in Sacramento.
Hall started with the Plumas County Public Health Agency in 1999 and has worked her way up from her first position as a health educator to director, with stints as a consultant and Assistant Director of Sierra County Health and Human Services, in Loyalton, along the way.
Hall said that her experience working at lower positions in Public Health in Plumas County has influenced how she manages her staff at the Agency today.