ncrc
Published 12:00 am Wednesday, December 2, 2009
By Emily Ford
Salisbury Post
KANNAPOLIS ó So just what is the Cabarrus Health Alliance anyway?
Dr. William F. Pilkington has been answering that question for 10 years, ever since Cabarrus County disbanded its health department and created an independent authority in its place.
The health alliance acts as a public health department, only faster and more flexible, Pilkington said.
Without bureaucratic and political constraints, the health alliance aggressively seeks outside funding, serves patients no matter where they live and functions like a private business with a public mandate.
It can create a new job position in two days instead of two months and pays dentists market rate (six figures) instead of $87,000, Pilkington said.
The health alliance put a nurse in every Cabarrus County public school in 2001, the first in the state to do so, and has an ultra-modern 16-chair dental clinic in Concord with a computer at each station.
Its primary care clinic in Kannapolis has grown by 50 percent every year for the past decade, he said.
From 80 employees and a $3.5 million budget in 1997, the health alliance has vaulted to 300 employees and an $18 million budget today.
“We have remarkable growth,” Pilkington said.
Harvard University named the health alliance one of the top 50 Innovations in Government in 2006. The N.C. Institute for Public Health called it an “incubator of innovative public health ideas” in 2004.
Last year the health alliance won a prestigious $600,000 grant from the Robert Wood Johnson Foundation to redesign public health business practices. Then it started a collaboration with IBM to reduce infant mortality using electronic medical records.
Key players at the N.C. Research Campus are eager to work with the health alliance.
“It’s one of the best public health departments in the country,” said Victoria Christian, chief operating officer for the Duke Translational Research Institute and the MURDOCK Study.
Christian invited Pilkington to Duke last month, where he dined with senior leadership and toured the Duke Children’s Hospital with renowned pediatric oncologist Dr. Joanne Kurtzberg, who performed the first umbilical cord blood transplant.
Pilkington then presented his plan to create “the model public health department for the 21st century.”
Faculty and staff at the conference were impressed, Christian said.
“He’s certainly got a lot of fans at Duke,” she said.
And at the University of North Carolina at Chapel Hill, where the School of Public Health wants to collaborate with the health alliance on projects including a state-of-the-art child-care center in Kannapolis, said Dr. Steve Zeisel.
Zeisel, director of the UNC Nutrition Institute at the N.C. Research Campus, said parents will line up to enroll their children in the day-care center, where they could participate in cutting edge research on childhood obesity and nutrition.
If the Cabarrus Health Alliance is so successful, then why is Hertford the only other county with an independent authority instead of a public health department?
Politics, Pilkington said.
“County commissioners do not want to lose control over public health,” he said. “They see it as a risky endeavor. What happens if it fails?
“They feel like it will be mismanaged and the county will have to come in and spend millions of dollars and rescue it.”
Health department employees often resist the change as well, Pilkington said.
“They are willing to sacrifice more money for the job security of working for the county,” he said.
Nearly 20 percent of his workforce quit when Cabarrus switched to the health alliance, Pilkington said.
Now, his turnover rate is down to 4 percent.
Seventy percent of the health alliance’s funding comes from grants, including about $3 million from the county ($26 per capita).
The remaining 30 percent comes from patient fees, including medicaid and private pay.
The health alliance primarily serves people with no ability to pay, Pilkington said.
“About 20 percent of our patients have some ability to pay and could go elsewhere for their health care,” he said. “But they choose us.”