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December 28, 2006

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Unfit to commit?

County might end contract for nutrition and fitness programs


The Humboldt County Public Health Branch might terminate a three-year contract with the state to lead a regional health collaborative and opt out of a one-year renewal because it has been unable to attract permanent employees to run the program.

The Northcoast Nutrition and Fitness Collaborative (NNFC) oversees healthy-living programs across Del Norte, Humboldt, Mendocino, Lake, Napa and Sonoma counties, with a bulk of its efforts spent reaching low-income families and especially children. More than 25 organizations, many of them from Humboldt, network with the NNFC to launch healthy-living programs. The state contract awards $500,000 to the program leader yearly, which doles out salaries and mini-grants for programs such as Farm to School and the Boys and Girls Club.

"To turn away big money doesn't make much sense," said Kathy Embertson, nutrition education specialist with the Humboldt County Office of Education. But the public health branch disagrees, saying that when they can't find employees to staff the project they have to give back the unspent money to the state, and that's a disservice to everyone. For a while the program limped along using consultants, but in November the consultants were laid off because the county said only permanent employees could be funded with the grant money.

Exactly why Humboldt has had trouble hiring a permanent project coordinator, health education specialists and nutritionists is not exactly clear. Alex Wineland, the branch director, says the problem lies in personnel -- it takes months to recruit, hire and process paperwork for a new employee.

But others close to the NNFC say the county's pay scale is inadequate -- insulting, really. A nutritionist with a master's degree makes around $13 an hour, they said: hardly enough to feed a family, never mind buy a house and settle down.

The grant is set to expire in September 2007, but directors with the Humboldt County Public Health Branch have talked with the state about ending the contract sooner so that the state has time to find a new leader -- perhaps the Sonoma County Public Health Division. That way, at least, the grant would continue.

"My recommendation," said Mike Goldsby, health program manager with the Public Health Branch, "is that we transfer leadership but not stop participation -- and it's just a recommendation."

Local members say that having the leadership centered at the Humboldt County Public Health Branch gives them easy access to professional nutritionists, dietitians and public health experts. They worry that if Sonoma County takes over the contract, Humboldt -- with issues unique to a sprawling rural area -- will be gradually forgotten.

"We see this as a serious problem," said collaborative member Linda Prescott, a registered dietitian with the Humboldt County Office of Education.

Another NNFC member, Helga Burnes, the nutrition grant project coordinator with the Del Norte Unified School District, said this program has brought obesity issues to the forefront in counties that desperately need intervention. Humboldt and Del Norte lead the state in rates of "food insecurity" (uncertainty about where one's next meal will come from). Additionally, the most recent state statistics, from 2002, reveal that Humboldt leads the region in the percentage of overweight 2- to 4-year olds from low-income families. The logic is that low-income families often eat fast food, consuming more empty calories and less fruits and veggies. The perceived time, effort and expense to cook healthful meals dissuades them from eating better. Programs funded through the NNFC aim to recognize and reverse these trends.

"This [program] has brought ideas together," Burnes said. "When [you're in a] rural area, you have no idea what others are doing."

Prescott, Burnes and a number of other area NNFC members from groups such as the Farm to School Program, Manila Community Center and even the Del Norte Unified School District -- all of them happened to be women -- met last Wednesday in Eureka to discuss what they called a "crisis."

A week before, on Dec. 11, they had a conference call with the California Department of Health Services in which they learned about Humboldt County's intention to end the contract. It shocked and disappointed them, not only because the program they've thrown their weight behind for more than two years now hung in the balance, but because the county's leadership never discussed it with them.

Now, they're calling on Humboldt County Supervisors John Woolley and Jimmy Smith to investigate the problem. Last week both Woolley and Smith requested an analysis of the program from the county's Department of Health and Human Services. If the county public health branch wants to end the contract, they will need the supervisors' consent to do so.

Woolley is optimistic that the program can be saved but he has yet to see the department's analysis, which will not be ready until sometime in mid to late January.

"There could be perhaps a way to revamp the whole budget to increase the amount of salaries that may help in recruitment," Woolley said. "But that will take some time to get processed. Then they need an extension. So there are a lot of negotiations that have to take place. It is not uncommon to have something like this happen in a large bureaucracy."

Already some programs are feeling the effects of the stalled negotiations, including Food for People, a local food bank. Food for People's workers go to the county's most far-flung (and poorest) areas -- from Orick to Willow Creek to Redway -- and teach people how to make healthy meals on a limited income. One nutrition class worked with teen parents. The participants were surveyed after each class and 89.3 percent said they learned something new about incorporating fruits and veggies into their diets. Food for People had intended to continue the program, funded by a $4,999 mini-grant, this January. But now it's on hold.

"The grant was approved but I don't know how this latest shift in the collaborative might impact that," said Anne Holcomb, director of Food for People. And Kathy Embertson said the state told her that "Humboldt County will have a black mark against it if the contract expires."

And there's the rub. With Humboldt serving as the hub for this regional collaboration, it places local health-related organizations at an advantage to receive even more state and county funds. When big philanthropies such as the California Endowment and the Humboldt Area Foundation see that Humboldt groups have easy access to a cadre of professionals, they feel more secure in the grantee's success. In the past three years alone, says Prescott, $3.3 million in grants has filtered into Humboldt County. Public Health Branch Director Wineland is adamant that the county still has the public's best interest at heart and that the health department will continue to support nutrition and fitness programs.

"We wanted to make it work," said Wineland. "We wanted to do this work, but we don't have the people to do it. So if [the contract] goes to Del Norte or Sonoma, we will do the same work and get the same information to people to eat with better nutrition. We won't be left in the dust at all. If we don't have people to pay, it is not helping the state and it is not helping the region and it is not helping us."



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