Category Archives: Public Health Heroes

A Small Thank You to Peggy Lou Hillman

Mallory Metzger, Immunization Law Health Educator II, Oregon Immunization Program 

It is hard to imagine the school immunization process without Peggy Lou Hillman. That’s because she has been there from the beginning. Soon Peggy will be retiring from the Oregon Immunization Program after nearly 50 years of working in public health. Peggy is an immunization school law and forecasting expert, resident historian, seasonal decorator, and number one advocate for our partners.

Whether or not you know Peggy, you know her work. Go outside and take a deep breath and thank Peggy for the clean air.  After college, Peggy began working at the Tuberculosis and Respiratory Disease Association where she helped institute clean air requirements and car emission testing. These policies have led to the Department of Environmental Quality car emission testing that we see today.

 

Peggy

Peggy Hillman, Immunization Law Health Educator II, Oregon Immunization Program

 

After you take that deep breath, walk over to a school yard and watch kids running and playing outside. These healthy kids can thank Peggy for helping create the first immunization laws for school attendance in Oregon back in 1981. As the Immunization Program Coordinator for Multnomah County, Peggy hand-wrote thousands of exclusion letters in the early years of the law.

Once you have gone for that walk, get in a car and drive with a sense of safety because all the babies being driven around are in car seats. Yep, that’s her too. While at Multnomah County, Peggy started the car seat loan program, which ensured all families regardless of income could protect their babies.

When asking Peggy about her career in public health she responded, “I fell into a career that I didn’t even know existed and it has given to me as much I have given to it.”  You have given to us more than we can fathom. On behalf of the Oregon Immunization Program and all those living and breathing in Oregon, thank you Peggy!

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Program Spotlight: The Oregon Breast and Cervical Cancer Program

January is Cervical Health Awareness month, and we are spotlighting a program at the Oregon Health Authority that works on an issue often related to HPV: cervical cancer.

The Oregon Breast and Cervical Cancer Program (BCCP) helps low-income, uninsured, and medically underserved women Oregonians gain access to lifesaving screening programs for early detection of breast and cervical cancers. Each year, approximately 4,000 people in Oregon receive services through the BCCP.

Since the program began in 1995, 71,509 women have received cancer screening, and 56,780 have received clinical services.  Fifty eight invasive cervical cancers have been detected, and 541 have received pre-cancerous cervical diagnoses.

“The BCCP saves lives through screening, early detection, and referral to treatment,” says Kristin Kane, Manager of the program. “Through this program, we can make sure that Oregonians have access to these essential services, regardless of whether they have insurance that covers these services.”

For program eligibility, visit www.healthoregon.org/bcc

The BCCP follows the United States Prevention Services Task Force (USPSTF) recommendations for cervical cancer screenings, which consist of the Pap test and high-risk HPV testing.  Women between the ages of 21-64 should receive a Pap smear every 3 years. For women ages 30- 64 who want to lengthen the screening interval, they can be screened with a combination of Pap smear and HPV testing every 5 years.

The BCCP is funded by the Centers for Disease Control and Prevention (CDC), Susan G. Komen for the Cure, Oregon and SW Washington Affiliate, and Oregon State general funds. Also, the BCCP partners with the American Cancer Society to run a patient eligibility hotline.

If you would like to learn more about breast and cervical cancer prevention resources in Oregon, please contact our program at 971-673-0581 or visit http://www.heatlhoregon.org/bcc

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Planning for the worst: Emergency preparedness at its best

By Erin Corrigan

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Over three days in May, 2013, the Oregon Immunization Program participated in an exercise in emergency preparedness called PACESetter. It began in Atlanta and reached all the way up to Washington State, involving federal, state, tribal, county, city and private agencies. We were presented with the simulated scenario that bioterrorism and other attacks were made against citizens in five Oregon counties as well as Clark County in southern Washington. The intent was to respond to these simulated attacks exactly as we would in real life and to test our ability to share information not only across jurisdictions in Oregon but also across state lines with Washington.

In response, the Centers for Disease Control and Prevention (CDC) shipped medical supplies that we received at Oregon’s Receipt, Stage and Storage (RSS) area. Our team helped unpack and redistribute the supplies to Oregon’s impacted counties. We also activated our Agency Operations Center (AOC), which acts as the command center where planning, operations and logistics such as requests for federally funded medical supplies are coordinated and documented.

The RSS area works as a well-oiled machine with staff efficiently breaking down large pallets of material, including items from our Strategic National Stockpile (SNS), into smaller lots to be distributed where they’re needed. The AOC, on the other hand, is more like carefully controlled chaos with information coming in constantly that changes the scenario and the required response. In addition, the exercise planners always throw in unexpected events or additional threats that change the game to make sure participants are nimble and able to switch gears as needed, which is exactly what would be likely to happen in a real attack.

This exercise was a full-scale exercise (FSE), meaning that we used all aspects of the state and local agencies’ planning and response resources, from immunization program staff to emergency management staff to medical response teams, state partners and even the governor, who had to declare a state of emergency (a fake one, of course). We are required by our CDC federal emergency preparedness grant to conduct an FSE every five years. The purpose of any emergency preparedness exercise is to ensure that the state’s public health and medical services can respond to a complex public health incident quickly and effectively, mobilizing teams that are prepared and well-trained.

Our goal in these exercises is just as it is in our everyday work: to improve the lifelong health of Oregonians through our vision of a healthy Oregon. 

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Lorraine Duncan: Determined and dedicated

Lorraine Duncan

Lorraine Duncan

Sometimes a job defines the person, but in Lorraine Duncan’s case, the person defines the job. After 33 years as the Oregon Immunization Program’s manager, Lorraine is retiring. During her tenure—which has lasted exactly half her life—she has come to personify excellence in a state program that has risen to become a national leader.

Before starting her job with the state, Lorraine had a varied career in social services. Fresh out of college, she worked as an adult caseworker for Multnomah County Welfare for two years. “My caseload was on skid row,” she says. “It was a real eye opener for me.” She then worked in Las Vegas for a bit after her twin sister Lois lured her to live in Nevada. “My husband Robert couldn’t stand it! For someone from Oregon, it was impossible for him to live in a place where there isn’t a blade of grass except for Lake Mead. In the summer, when it got so hot the gas in our cars was boiling, he moved back to Oregon. I had to stay to finish out my contract.”

When she returned to Portland to reunite with Robert, Lorraine worked in a few venues, most notably as the director of special programs for the Portland Metropolitan Steering Committee on such projects as improving the health of African Americans and developing a healthcare precursor to the Oregon Health Plan.

On April 1, 1980, Lorraine became the program manager for OIP, a job that has lasted 33 years to the day. “We went from five employees with a tiny budget to 60 employees with a huge budget,” she says. When she started, there were only a few vaccines, no registry and no Vaccines for Children program. Some of Lorraine’s favorite accomplishments include helping to form coalitions and advisory groups such as the Oregon Partnership to Immunize Children (OPIC) as well as the Immunization Policy and Advisory Team (IPAT). “Those partnerships are so helpful. They’re a lot of work but they so pay off.” Lorraine is also proud of helping to build a statewide registry from scratch. Today, the ALERT IIS is considered one of the best immunization information systems in the country.

Lorraine is considered a superstar on the national immunization stage. “She has been a mentor to me in both program management and leadership in our national Association of Immunization Managers (AIM),” says Janna Bardi, Washington State’s immunization program manager. “I’ve really appreciated having one of the best immunization program managers in the nation right next door. Lorraine’s contributions to AIM are huge. She served as chair twice and made a suggestion for structuring quarterly leadership meetings with CDC that has greatly strengthened communication and relationships.”

Though Lorraine is well known and loved across the country, she is most admired and remembered by the people who have worked with her. Dr. David Fleming, public health officer for King County in Washington State, was OIP’s medical director before Dr. Paul Cieslak. “It’s hard to imagine that anyone could have done more to assure the health of Oregon children than Lorraine Duncan,” says Dr. Fleming. “And to have that dedication and skill packaged inside such a caring person brightened my day more times than I can count.”

The people who work with Lorraine on a daily basis feel very fortunate. Many mention her steadfast leadership and the way she pushes the program to achieve important new goals. “Lorraine’s mentorship has been invaluable. She’s taught me much about life in the world as a government agent with a real heart for those we serve. I will forever be grateful,” says Mimi Luther, OIP’s provider services manager who has worked with Lorraine for 15 years. “She’s an amazingly hard worker who truly values the input and creativity of those around her.” 

Lorraine is a notoriously dedicated supervisor. “I worked a lot of extra hours and I got a lot of flack for doing it,” she says. “But I liked doing it and I kept doing it.” She says that she is hardly ever sick and gets up every morning wanting to go to work. As proof of her dedication, she is retiring with an accumulation of 3,067 hours of sick leave!

 Lorraine also has a reputation for being extremely knowledgeable about all the complicated aspects of immunization. “I’m in awe of the number of details she’s able to keep in her head— about vaccines, grants, meeting deliberations, legislation. You’re going to have to hire three people to replace her,” says Dr. Paul Cieslak, OIP’s current medical director

Lorraine’s secret to her longevity in one job is simple: “I love coming to work. I love the people, I love my job. I love coming to work every day.” She isn’t worried about the program surviving after she leaves with such an “excellent staff.” But she does wonder what she will do in retirement when she leaves at the end of a six-month transition period in September. “Travel, of course (Lorraine and Robert are world travelers), but maybe I’ll find part-time work,” she says. “I can’t imagine not having a job.”

EDITOR’S NOTE: Get ready! Oregon Immunization Program’s ImmiNews e-newsletter will now be coming at you every single Wednesday, full of the latest immunization news from across Oregon and the world! Tell your colleagues and friends.

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Isabel Bickle: A life dedicated to public health

 By Jody Anderson

“Never a Dull Moment” is the title of the book Isabel Bickle plans to write now that she’s retired from the State of Oregon’s Division of Human Services Office of Medical Assistance Programs (DMAP).  While “policy” may not be a word that causes most of our hearts to flutter, Isabel seems delighted to have lived and breathed policy for most of the last 28 years. Her enthusiasm for policy shines through when asked about what stands out in her career. She says, “I believe in rules—you can’t function without rules.” She notes that you that you can’t run a household without rules, you can’t raise kids without rules and you can’t have a health care system without rules.

Isabel’s career has been far from dull. In her role as a medical policy analyst, she has been a part of making history over and over again. When the Oregon Health Plan (OHP) came into being, Isabel was instrumental in creating the first ‘Prioritized List of Health Services’ where diagnoses and procedures were paired. Isabel assisted the medical director in final decision making of the diagnoses on the List. She knew at the time how revolutionary the OHP was in health care provision. “This was totally new,” she says, “and nothing like it in the world. I didn’t even know if it was even going to work. But it did. This allowed coverage of the most appropriate treatment.”

Isabel seems to have touched every area of Public Health. According to Lorraine Duncan, Oregon Immunization Program (OIP) manager, Isabel “made our working relationship with DMAP an outstanding experience. She ­was always buried with work but she always made time for immunization. We should thank her from the bottom of our heart!” Isabel’s contributions to OIP included making sure the immunization coding was accurate and up-to-date with the Advisory Committee on Immunization Practices (ACIP), driving to Portland to attend the quarterly ALERT Advisory Committee and Immunization Policy Advisory Team (IPAT) meetings where her input was invaluable, and processing the S-Chip bills (an essential revenue source for the OIP). But most of all, Isabel was always available to help OIP troubleshoot problem areas.

Isabel recalls working with OIP on the ALERT Registry “for many years before it was implemented,” helping with the flu vaccine shortage and working with coding issues during the H1N1 epidemic. She says that the Public Health Division “was the driver, but we [DMAP] were there in supporting them, and answered questions for our providers too.”

Karol Almroth of Oregon Reproductive Health Program says that Isabel “has been an ally to our program for many years, particularly around contraceptive meds and supplies.  She participated on the original work group that developed and implemented the Medicaid Family Planning waiver program (currently known as CCare), contributing her extensive knowledge of Medicaid reimbursement of medications.  She is our resident expert to this day.”

When asked what the most notable moment of her career was, Isabel doesn’t hesitate, “At Medicaid, the most notable was the denial of a liver/lung transplant. It was a difficult decision to make; but I denied it because of the rules. The rules just didn’t allow it.” The decision was widely covered by the media, and ultimately challenged, but upheld by the court. “Your heart goes out to approve a service but you have to make your decision based on the rules,” says Isabel when she talks about the decision, “Here I was a nurse just doing her job, and just doing it correctly, but I just got through that storm.” While the denial of the combination lung/liver transplant was criticized by many, Isabel remembers receiving a note from a woman afterwards and it read, “You saved the lives of two people: a lung recipient and a liver recipient.” The woman signed her name and the year she received her liver. Isabel took it as confirmation that she made the right decision.

What advice does Isabel have to offer to the rest of us? About work she says to “learn what you can, make the best decision on the knowledge at the time, always be open to new information, listen to a new opinion and weigh it, and change the policy if you need to.”

From a larger perspective, Isabel says, “There’s still life after work. You’re not finished, and it’s another adventure—I’m having the time of my life. I love what I do, I really do, but it’s just a change I was going to need to make. When I made the decision to retire it’s made me so happy. If you have 30 days to live, what would you do? Make amends, do the things you want to do—tell someone “I love you.”

There’s no doubt that that our state is losing a treasure, but we can look forward to hearing more from Isabel in her retirement. Besides baking and coding, Isabel still does have that book to write. “Never a Dull Moment” seems a fitting title.

 

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