AS COUNTY DECLARES HEALTH EMERGENCY OVER HEPATITIS, STATE LAUNCHES INVESTIGATION OF PUBLIC HEALTH NURSING SHORTAGE IN SAN DIEGO

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By Miriam Raftery

Photo:  Jaundice, or yellowed eyes and skin, is one tell-tale sign of Hepatitis.

September 3, 2017 (San Diego) – The Joint Legislative Audit Committee on Thursday approved by a 10-3 vote auditing San Diego County’s Health and Human Service Agency for what Service Employees International calls “dangerously low staffing levels of public nurses.”  

A media advisory from SEIU states that public health nurses in San Diego County have been chronically understaffed, with some nurses having caseloads of up to 1,000 patients. 

One day after the state ordered its investigation, the County declared a public health emergency due to a hepatitis A outbreak that has killed 15 people and sickened hundreds.  “HHSA is reportedly pulling nurses from their assignments because of this, reducing access for other at-risk groups,” says the advisory from SEIU. 

State Senator Ben Hueso calls the nursing shortage unacceptable, adding, “We must investigate why HHSA is failing to respond appropriately to this health crisis.”

The California Dept. of Health and Human Services sets a cap of 400 California Children’s Services cases per registered nurse.  Current staffing assignments average 760 in San Diego County. Similarly, local nurses are handling over 326 foster children, despite a state cap of 200 per nurse.

SEIU local 221, the union that represents local public nurses and certain other county employees, has said it will strike on September 12-13, over what it has called unfair labor practices.

Under the public health advisory called Friday night by the County of San Diego, the County pointedly criticized the City of San Diego for unsanitary practices that have enabled spread of Hepatitis A among homeless people.  The County has now hired a private contractor to deliver 40 hand-washing stations in places where homeless people congregate by this weekend.  In addition, street-cleaning crews will blast high-pressure water mixed with bleach to remove bodily fluids from city streets, a plan modeled on successful efforts in Los Angeles. 

The County has been pushing vaccinations of homeless people and those with whom they come in contact, but thus far it has not been successful in reducing spread of the disease, which can be transmitted through fecal contamination, sharing dirty needles or contaminated eating utensils.  Medical personnel, social workers, food handlers and others have been urged to get vaccinated, along with homeless people and others at risk.

The San Diego Union-Tribune reports that the city issued a press release Friday saying it will comply with the County’s requirements but may take up to 10 days to wash streets due to notification requirements.  Critics are asking why such steps weren’t done sooner.

Councilman David Alvarez told the Union-Tribune, “It just infuriated me that the bureaucracy was getting in the way of doing the right thing.”

ECM asked Councilman Gary Kendrick, which also has a homelessness issue, whether El Cajon has considered hand washing stations or power washing streets and sidewalks.  Kendrick said the city should look into the issue but was under the belief that cities can’t power wash sidewalks and drain it into the storm drains.

Kendrick added that he is not sure whether any of the Hepatitis A cases have occurred in El Cajon but will look into it.  “Certainly, the city of El Cajon will be cooperating if there is a danger here in El Cajon,” he concluded.


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