Jeanne Sager | Democrat THE PORTICO OF the Western Hotel in Callicoon, above, is cordoned off by crime scene tape Sunday morning after a shooting death hours before.

NYS Health Commissioner gets a bedside look

By Jeanne Sager
LIBERTY — April 15, 2008 — A campaign to make New York the “healthiest state” will have a portion of its roots in Sullivan County.
Kicking off the campaign, New York State Health Department Commissioner Dr. Richard Daines spent much of Thursday visiting the county.
It was the fourth day of activities celebrating National Public Health Week, which began with Daines’ unveiling of “Prevention Agenda Toward the Healthiest State” last Monday in Albany.
His tour of health programs in Watervliet, Lake George, Kingston, Binghamton, Walton, as well as Monticello and Liberty, were aimed at giving the state-wide initiative local roots.
The state’s diversity makes it impossible for Albany to write a broad-brush program, Daines explained.
“You really have to adapt those initiatives to local conditions,” he noted.
The goal of reducing accidental deaths, Daines said, can be met with window guards in New York City where toddlers have been known to fall out of open windows in high rise apartments. In his visit to the Cooperstown area, he said, he heard less about window guards and more about tractor roll-overs.
That’s an approach to the goal that he’ll take back to Albany.
Meeting with the Latino Service Providers Coalition at Sullivan County Public Health in Liberty, Daines said he learned that tobacco use – one of the hot items on his prevention agenda – isn’t a major concern in the migrant population.
Again, that’s a different outlook on his agenda that Daines will take back to Albany as his staff begins to put the campaign into action.
Daines took advantage of an afternoon dedicated to Sullivan County to visit Hudson River Healthcare in Monticello to observe a diabetes management model that’s working with low-income patients, then moved on to the county’s public health office in Liberty for his meeting with the coalition.
Walking out of the meeting, Daines was hustled into a car with Public Health Nurse Jessica Schwatz, who let him tag along on a visit to the home of one of her favorite patients in Liberty.
Shirley Haire said Schwatz and the folks with the long-term care program run out of Sullivan County Public Health are responsible for keeping people like her in the community.
“If it wasn’t for Jessica and the people at long term care, we’d end up in nursing homes most of us,” Haire told Daines. “They’re always in touch with us, always checking in.”
She met Schwatz when her late husband, George, was in ill health. Now the two joke like old friends while Schwatz pulls out her stethoscope to take a listen to Haire’s lungs.
Suffering from chronic obstructive pulmonary disease (COPD), high blood pressure, glaucoma and congestive heart failure, Haire “took a fall” last November trying to get George into her son’s truck.
“I didn’t see the ice, and I slipped under the truck,” she explained to Daines, who spent much of his visit to Haire’s apartment seated an arm’s length away, his eyes trained on the scene unfolding in front of him.
Once a family doctor, the health commissioner gently peppered Haire with questions while Schwatz ran through her checklist, even popping up to borrow the nurse’s stethoscope and take a listen himself to her lungs.
Daines took obvious delight in the repartee between nurse and patient – a sign that the folks at public health are as invested in their patients as folks like Haire are in them.
“These local public health people, the challenges they have – in these smaller counties especially – the challenges are so much because they have to DO so much.”
With a smaller staff and a population spread out over a large rural area, Daines said he has a hearty respect for people like Sullivan County Public Health Director Carol Ryan.
“She has to be 10 different people in one day!” he said.
Public health in the smaller counties does have the advantage of being more personal, he noted.
“Look at the rapport these two have,” Daines said, pointing to Schwatz and Haire, “happy to talk about the cat and the kids.”
He marveled too at the adaptability of the small public health departments which have integrated technology into their every day business to better meet the needs of the patients and tackle the challenges unique to rural life – chief among them transportation.
“It’s so much easier to take a device to the patient’s bedside than to take the patient 10 miles to the hospital just to prick a finger,” he said with a laugh, harkening back to a conversation he’d had with Haire a few moments into the visit.
With her COPD in mind, Daines reasoned it must be much easier on Haire to have Schwatz draw blood on a regular basis that would otherwise have to be drawn in a doctor’s office.
“I remember my patients would come in out of breath, and I’d ask, ‘How are you doing at home?’” Daines related. “They’d tell me, ‘At home, I’m fine, but getting to the office is such a hassle.’ These home visits are great.
“And I like to see how they’re integrating technology,” he continued. “You have the old-fashioned visiting nurse with a laptop computer!”
Last week, Daines was collecting his research the old-fashioned way with a tour around the state. Now it’s time to integrate what he’s learned into a prevention method for the future of New York.