In any jurisdiction,

the health department could be described as one of many government agencies

largely overlooked by citizens until they have an urgent, direct need

for it.

But the Fayette

County Health Department, like many other areas of the growing county

government, is working in areas that many people probably do not realize,

and with a volume of cases that would certainly surprise many local residents.

It is easy to see that every resident of Fayette County, and every person

who comes here from outside the county each day to work, benefits from

these services.

Overseen by

the county's Board of Health, a body consisting of people appointed by

the Board of Commissioners, the Health Department also answers to District

4 Public Health, which comprises 12 counties on the south side of Atlanta.

The two major

divisions of the county department are Physical Health and Environmental

Health. County nurse manager Cynthia Grant leads a staff of eight administrative

persons, five full-time nurses and one part-time nurse in the Physical

Health section. Richard Fehr is in charge of Environmental Health, which

consists of a staff of eight.

Immunizations

are the first thing people usually think about when they think of the

Health Department, but the work done there involves much more than that.

All nurses

are expanded-role nurses, meaning they can dispense medicine by protocol,

or without a doctor's prescription.

They do pap

smears and family planning exams, give out birth control pills, and check

people for sexually transmitted diseases. Blood work for marriage licenses

and STDs is a regular part of their average day.

Grant estimated

that about 70 percent of her office's patients initially come for financial

reasons, although many keep coming back because of the relationships they

develop with the people who treat them. Many adults who were immunized

she said.

The Fayette

County office can handle virtually any travel immunization you might need,

including protection against malaria and yellow fever. In addition to

the many Fayette County residents in the travel industry who regularly

need this service, a large number of people come in for shots before leaving

the country for mission work, Grant said.

Health Department

officials dispense WIC (Women, Infants and Children) vouchers for food,

but they also give nutrition counseling so that voucher recipients and

others can learn how best to use the food they have.

Infectious

disease monitoring, for such cases as tuberculosis, are handled by the

Health Department. In fact, while actual house calls are far fewer now

than they were years ago, infectious disease monitoring involves regular

trips to the patient's home so that he or she can remain isolated.

A refugee health

program is also available to be put into place whenever the state gives

notice that new refugees are in the county, Grant said. As with many other

county departments, her office is becoming more multi-lingual to deal

with the growing immigrant population, having dealt with Vietnamese and

Pakistani patients in recent years, to name just two examples.

While direct

involvement in local schools is not as great as in years past, the Health

Department still gives Hepatitis B immunizations to all sixth-graders

and does scoliosis screenings. Health fairs and appearances at area churches

are also part of the regular schedule.

On the environmental

health side, one of the primary tasks is the inspection of the more than

200 restaurants in the county, a figure that Fehr says changes almost

on a weekly basis, with eating establishments opening and closing continually.

The state requires

inspections at least twice a year, Fehr says, but his department tries

to visit each location at least 3-4 times, and depending on customer complaints

the number could be higher.

"There's

a pretty consistent increase in the number of restaurants," said

Fehr. "That's because of an increase in people that not only live

in the community but visit here or work here."

Health Department

officials also inspect tourist accommodations motels and hotels, of which

there are currently eight in the county.

Recent adoption

of new swimming pool regulations by the county Board of Health means a

big change in the department's responsibilities. Whereas the county formerly

inspected public pools at tourist accommodations and wherever complaints

were lodged, inspections will now be conducted on a regular basis at all

public pools, including apartment complexes and subdivisions.

The Health

Department provides bacteriological testing for private wells when it

is requested. The state does not mandate that every well owner have such

testing, but if it is desired the county must be available to provide

it, Fehr said.

Aside from

restaurant inspections, the biggest day-to-day responsibility of the Environmental

Health office is on-site sewage inspection for every new residential and

commercial construction project that has running water and is not on a

sewer line. Also, when a lending institution make a particular request,

the county will give an up-to-date inspection or on-site sewage system

or private well.

One of many

local organizations participating in the National Safe Kids Coalition,

the department takes very seriously its involvement in injury control,

having been recognized statewide with a Best Coalition award in 1998.

A fact that

may surprise many taxpayers is that the Health Department mostly supports

itself financially. Most of its $1 million annual budget comes from the

various fees paid by patients for immunizations and other services, plus

fees paid by restaurants and other businesses. Some funds are received

from the state and the county.