Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
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Clarion-Ledger (Jackson) (12.06.05) - Tuesday, December 13, 2005
Jerry Mitchell
According to the PEER report, department employees were instructed in February 2003 "at the risk of their jobs" they had 90 days to increase the number of TB patients currently in therapy from 80 percent to 95 percent. To attain that goal, staff changed the definition of what constituted "current in therapy," resulting in a 6 percent increase.
Field staff also failed to initiate TB therapy on those it knew "would be difficult to maintain current on their treatment," such as the homeless and other high-risk groups, said the report, noting this "could represent a future public health threat, as untreated cases could become active."
"Despite the inefficacy of this effort at performance improvement, as recently as July 2005, the department continued to highlight on its Web site the 2003 'current on treatment' emphasis for patients with latent TB infection as a performance improvement success," said PEER.
PEER Executive Director Max Arinder said the health department suffers from serious morale problems. PEER found failed efforts to improve quality; unnecessary restriction of professional channels of communication; a failed budgeting model; and the loss of experienced employees. PEER said Dr. Brian Amy, who took over as state health officer in October 2002, had reorganized the department at least four times without board approval, a violation of Mississippi law. In response, Amy wrote that he has the authority to reorganize without board approval because state law gives him "all the authority of the board when it is not in session."
Larry Calvert, chairperson of the state Board of Health, said he plans to appoint a committee in January to look into the issues raised by PEER.
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