Welter's new programs with the Flagler Department of Health help those who once had to travel out-of-county
Bonnie Welter remembers when Flagler County’s total population was no more than 30,000 people. It was 1986, when she first became involved in the county’s public health, in the thick of America’s HIV/AIDS crisis.
Things have improved much since then. Now the executive community health nursing director, Welter said the public health field overall has gotten better talking to people about sensitive subjects like sexually transmitted infections — she was behind the addition of a community STI surveillance program within the last few years — and vaccinations save more kids from chicken pox, pneumonia, influenza and other threats to fledgling immune systems.
“I have a big passion for children,” Welter said. “I want them to have the support they need to be productive adults.”
Working with Flagler County schools to provide school-based influenza vaccines is just one of the ways in which Welter has raised the efficacy of local public health resources. In her time with the Department of Health, she has started many new programs from the ground up and personally runs over a dozen of them. Most recent are 2019’s diabetes prevention program — a year of lifestyle coaching for the one-third of people with pre-diabetes— and diabetes self-management program.
"Bonnie's involved in virtually every clinical, public health, and educational program at the health department. She's one of the hardest workers here."
-- DR. STEPHEN BICKEL, physician at the Flagler DOH
Finding the community's needs
Welter said she gets emails from clients in the prevention program, thanking her for providing the support needed to make lifestyle changes. She gets around as many emails from HIV patients thrilled with the HIV program she started at the DOH in 2015, thrilled they no longer have to drive to Volusia County for help.
“The public needs to know that they’re not out there alone,” Welter said. “We’ve made amazing changes. Doctor’s offices are referring their patients to us.”
This is why the triennial community assessment currently being done for the county is so important; it will let the DOH know where their efforts need to be focused. Based on the results of the last assessment, Flagler’s most pressing public health concerns include mental health, adult and youth behavioral health and domestic violence.
Welter said the opioid crisis is another threat they are trying to keep at bay and that it is adding to the frequency of hepatitis C in the community. As bad as Florida’s hepatitis A emergency has been in 2019, hepatitis C has been a recurring hazard among older citizens and is expensive to treat.
“Every boomer should get screened for hep C,” Welter said.
A self-sufficient Flagler
There was a time when Flagler had to go to other counties’ health departments for resources. Welter made it her mission to see to it that Flagler County can provide for its own residents with her many programs, as with the HIV program or her bringing in an obstetrician for neonatal care so new mothers need not travel far.
When starting a new one, they first perform a needs assessment to decide which area of public health is not being adequately served. Once identified, the DOH looks for funding, whether in the form of small state health office grants or private funding. Then Welter looks for her staff.
“I usually work the programs from the bottom up,” she said, until she can bring in a trusted employee — possibly one of the nurses she has mentored from RN up to BSN — from another part of the department to run them without her.
All of her employees juggle multiple responsibilities in different areas of public health.
“We do not become siloed,” Welter said.
Passion to make a change
“This place tries to find a way to either treat people or get them to the resources they need,” said Gretchen Smith, the Flagler County Health Department’s public information officer. “I don’t often hear ‘We can’t do it.’ They’re more focused on ‘Let’s make it happen.’”
This quality is why Robert Snyder, the department’s chief health officer, called Welter “one of the best directors of public nursing in the whole state of Florida.”
“I love it,” Welter said. “I have a fantastic staff. Everyone here wants to have a healthy community.”
Her plans for 2020 include applying to the Centers for Disease Control and Prevention for recognition of Flagler’s new diabetes programs and establishing a colposcopy clinic in the county for those on Medicaid or without insurance.
“When we’re able to get funding for our priorities and we’re able to affect them, that’s what keeps me going,” Welter said. “It’s the passion to make a change.”