Cheryl King-Smith and Alisa Haushalter, photographed by Jon W. Sparks.
What goes on at the Shelby County Health Department affects every one of us, and in a remarkable variety of ways.
Alisa Haushalter, who has been director there for two-and-a-half years, oversees its numerous missions that include keeping statistics, outfoxing infectious diseases, chasing mosquitoes, preaching fitness, handling food commodity programs, keeping birth and death records, and rating restaurants.
Haushalter has a long history working in public health. She’s a registered nurse, has certification in Advanced Public Health Nursing, and has a Doctorate of Nursing Practice degree earned at the University of Tennessee Health Science Center in 2007. From 1983 to 2012, she was with the Metro Public Health Department in Nashville, then went to the private sector, continuing to work on community health issues. But she was contemplating getting back to public service when she was offered the Shelby County position.
She took the job that has a broad mandate. Even longtime locals may not realize the full scope of what the Health Department does:
- A main duty is assessing health conditions in the community, something as varied as heat-related illnesses and opioid-related overdoses and deaths. A big part of the department’s mission is dealing with infectious diseases, “which is the cornerstone of public health,” Haushalter says. The department diagnoses and treats cases of tuberculosis for free. It also tests and treats people diagnosed with sexually transmitted infections, and for individuals who have HIV, it tests and refers for treatment. “We also case-manage to make sure that people stay in treatment,” she says. “That’s a critical piece — for people to get treatment and stay in treatment.” There’s also an ongoing Hepatitis A outbreak in the country and in Tennessee, but as of the time of this interview, there were no cases in Shelby County, “so we meet weekly, sometimes twice weekly to look at our prevention strategy so we don’t have cases,” Haushalter says.
- Clinical services are provided that focus on giving people vaccines, primarily children. In addition to the main office at 814 Jefferson Avenue, the department has eight outlying clinics that do immunizations. Also available are family planning services and Women, Infant, and Children (WIC) services. Also provided are breastfeeding support, car seats and crib distribution, nutrition services, and pediatric dentistry. Federal programs to feed children and the elderly are also administered.
- The department deals with anything that impacts the health and well-being of children and family. There is a fatherhood initiative that works with young men in a variety of different settings to encourage their active engagement with children. Part of its mandate is also working with the community to reduce infant (up to a year) mortality, and separately, reducing deaths of children between 1 and 18.
- One of the department’s primary functions is working on health-related policies, a broad area that ranges from no-smoking policies to where sidewalks are located to encourage walking.
- Restaurant inspections fall under environmental services. The department also provides education to restaurant owners and staff to make sure they know how to keep food healthy and safe.
- Also part of environmental services is the mosquito control program. The bugs are monitored for specific diseases and areas are sprayed based on data. “We use that data and mapping to determine where to target and spray effectively so that we don’t have Zika spread as it did in Miami and other places,” Haushalter says. “We have what’s called vector control — mosquitoes are one vector, the other is rodents. If there are complaints of rats, we help the home or business owner understand what’s contributing to the infestation, how to get rid of it. And then we will bait for rats as well.”
- The Health Department has legal clout ready as well. Its attorney can close a restaurant or quarantine or isolate an individual to protect the community.
- The department is responsible for the health of all juvenile detainees and anyone incarcerated in either the sheriff’s facilities or the corrections facilities in Shelby County.
- “We’re also responsible for the medical examiner,” Haushalter says, “which is in partnership with the University of Tennessee. That allows us to monitor causes of death and to be able to adjust our programs to provide appropriate services to our community.”
- The opioid epidemic is getting considerable attention from the department, Haushalter says. It’s working with treatment and recovery providers as well as UTHSC, the U.S. Attorney’s office, and the county mayor and commission.
- Many people deal with the Health Department to get birth and death records. “It’s a big portion of what we do,” Haushalter says. “We have gone electronic, which has helped reduce waiting times: There are not long lines anymore. People can easily access and get their birth and death certificates quickly and we can do them for the whole state now where in the past we could only do them for Shelby County. This time of year sees a lot of people coming in for birth certificates and immunizations to get children ready to go back to school.”
- Disaster planning is addressed with the Public Health Emergency Preparedness Program that is set up for a rapid response to potential health risks in case of calamity.
- The department’s website (shelbytnhealth.com), has been upgraded to be more user friendly and will continue to add features to make health information more readily available.
When Shelby County Mayor Mark H. Luttrell, Jr. hired her, he said a priority was to build up the public health infrastructure, so one of her top priorities has been putting together new facilities. One will be a new $24.5 million state-of-the-art headquarters building at Jefferson and North Manassas next to the existing 68-year-old building that will eventually be demolished. Completion is expected in 2019. Improved parking and accessibility are a priority, she says.
Haushalter is overseeing other expansions and improvements in facilities as well as deepening relationships with area colleges and universities, particularly the University of Memphis and UTHSC. All this, plus an emphasis on funding to be more flexible in meeting the county’s health needs, is serving long-range purposes.
“That allows us to be seen more on the national stage,” Haushalter says. “That allows us to recruit more people. It allows us to be able to be more competitive for federal awards and grants. So those things are all moving forward and we hope to look at accreditation within the next year to two years, which would be a big step for us as a health department.”
Along with these changes, Haushalter foresees a greater emphasis on prevention in addition to treatment on the part of public health entities. Flexibility will remain crucial, and while current efforts are proving effective, there are ongoing challenges.
“A large number of our children are raised in poverty,” she says, “and it’s important that we work together to elevate people out of poverty, and ensure that they have opportunities for really solid education and solid jobs that make sure they have a living wage. Our responsibility in that equation is to assure that children are healthy, so that they can learn and that they can do well in the workplace.”
