May 24, 2016
May 24, 2016
Johnston County Health Department serves as the “physician for the community” for eleven towns and 168,878 residents just southeast of the Research Triangle region in North Carolina’s Piedmont. The department is led by Heath Director Dr. Marilyn Pearson, who started at Johnston County as the primary care clinic’s first physician. A well-respected and admired community member, Dr. Pearson leads her staff through the multiple changes the health department faces.
The Leadership Key
Among Dr. Pearson’s many distinctive leadership qualities is the ability to pull people together and make things happen. Her talent in framing health department messages that appeal to both individual and organizational values is another skill. She appreciates sifting through a multiplicity of ideas, and letting them germinate. Dr. Pearson describes her leadership style as inclusive: she encourages feedback and ideas from staff at all levels. She wants staff to take ownership over their projects, so her main concern is providing them with the support needed to complete those tasks. In order to do this, she explains that it is important to be a good listener and to remain open to different perspectives. Ultimately, Dr. Pearson hopes to inspire her colleagues to take on and overcome challenges together.
Additionally, Dr. Pearson sees her position as being the “physician for the community.” She views it as her job to be on different boards and committees to get the word out about the health department’s work as a safety net service provider. Although the health department is undergoing changes, its goal is to tackle community-wide issues, including access to care and providing chronic disease-focused education. Dr. Pearson also hopes to provide additional training for staff to adapt to their changing work environment.
Where Change is Happening
Recently, the health department took over the behavioral health services from Johnston Health, the local hospital. The health department brought stability through government funds to staff the patient and hospital unit serving behavioral health. The department’s ability to take over these responsibilities resulted from serendipitous timing.
“A few years ago, we talked with our mental health center about doing something with behavioral health. Our Local Management Entity (LME) applied for a grant and received the grant, which allowed us to have a licensed clinician in our health department,” Dr. Pearson said. “At the same time, that was when the big changes were happening in North Carolina with our mental health system converting to Managed Care Organizations (MCO).”
The LME realized that a LME MCO could no longer provide direct services for clients, but Johnston County does not have a wealth of private mental and behavioral health providers. The loss of a provider would leave 4,000 people without the care they needed. “This was a very vulnerable population,” Dr. Pearson said. “We decided that we would take on the safety net services and provide the direct services for those clients.”
The money that was designated to go to the LME went to the health department so the agency could provide both inpatient and outpatient behavioral health services.
“Our hospital has 20-man inpatient unit and our LME was also providing the psychiatrists that were taking care of people in the inpatient unit and doing the consults in the hospital,” Dr. Pearson said. “Mental health itself is a very big learning curve [for the health department] but also understanding inpatient/outpatient care became something very big.”
This transition offers new insights into patient health via the shared Electronic Medical Records which shows a complete picture of a patient’s care by including both the physical and behavioral health information.
“Everything is Public Health”
“We as a health department—one of the great things about us, at least in our county, is our human services agencies are located close together,” Dr. Pearson said. “All of us being in the same vicinity has allowed us to be able to do things together, and we have done that for a long time.”
Colocation of health and human services and healthcare agencies naturally resulted in improved communication and coordination. However true integration remains challenging. A healthcare, social services, and public health often have different goals so aligning those goals to a single area of focus that overlaps all groups is critical. Dr. Pearson also sits on the board of Community Health and Improvement and keeps her connection to the community strong. “I need to be out there talking to people so they understand what our role is and how we can impact things working together.”
Chronic disease focused education and groups are currently a focus for the health department, because of the lack of providers in their community. The health department recently received a grant that will focus on diabetes prevention, heart disease, and stroke prevention. This will include integration and collaboration with the faith community as well.
“Everything is public health,” Dr. Pearson said. “No matter what decision you’re making it’s all about health. You may think it’s economic but everything is health.”
“The Right Person”
Johnston County Health Department works closely with the local hospital Johnston Health. CEO and President of Johnston Health Chuck Elliot only has words of praise for Dr. Pearson. This praise is especially in regard to her presence on the board of Community Health and Improvement.
“She is well respected and gets things done,” Elliot said, “She pulled people together and got grants by ensuring the right people were at the table.”
Pearson’s leadership style plays a heavy role in her ability to unite others and create solutions for the health department. “I’m always asking my leadership team if they think there are things that I can do differently to let me know,” Pearson said. “I think I’m pretty approachable, I have an open door policy.”
In addition to an open door policy, Pearson sends out an evaluation form every year to get input from her staff. Pearson also encourages her managers to participate more in the community via community boards and committees. Pearson is also working on expanding department policy to allow staff to participate more in events like local festivals so they can promote health education in the community.
“Resource for the Community”
Looking forward, Pearson hopes that the health department will be part of, “a larger group of service providers.” Working with agencies and groups will continue, but working with the entire community at large is critical in order to expand services.
“In the future, we will morph into an agency that has different divisions,” Pearson said.
These divisions will include collaboration with the faith community and schools in order to expand beyond primary care. Other areas the health department is looking to approach include social issues like transportation, greater integration of care, and addressing mental health stigma.