The state’s top public health agency is not involved in the investigation of a county dental clinic in which sanitization practices prompted a warning that thousands of people in the county should be tested for exposure to hepatitis and HIV, a spokesman said Tuesday.
Local health departments, the Galveston County Health District in this case, are responsible for their own investigations, and the state agency provides assistance when it is requested, the Texas Department of State Health Services said.
“The Galveston County Health District is running the investigation into Coastal Health & Wellness,” state health department spokeswoman Lara Anton said. “DSHS has been assisting the GCHD by procuring medical supplies and staffing for testing patients. DSHS is not involved in the actual investigation.”
Anton declined to say when the agency was asked to provide help, saying that communicable disease investigations are confidential. She referred other questions to the county health district.
The health district said Friday it would be contacting about 9,500 people who had been treated at the Coastal Health & Wellness clinic over the past three years, and urging them to be tested for exposure to hepatitis B, hepatitis C and HIV.
Coastal Health & Wellness in February closed both its Texas City and Galveston clinics after an accreditation inspection identified 11 “immediate threat-to-life violations” in the way the clinic sanitized dental tools used between different patients.
The district has not identified anyone that has been infected at the clinic, but health officials have identified people infected with hepatitis C who were treated at the clinic and were later diagnosed with the disease.
Officials cannot say where or when those people were infected, which is part of the reason why the district began to notify other former patients about possible exposure.
Dr. Phillip Keiser, the Galveston County health authority, said state and federal agencies have been informed about the concerns at the dental clinic, although officials have not specified what role those outside agencies might have in the investigation or response.
The inspection that first flagged the issues at the dental clinic was conducted by The Joint Commission, a nonprofit group that provides quality accreditation to health care organizations across the United States. It is not a federal agency.
The U.S. Centers for Disease Control did not respond Tuesday to questions about its involvement in the investigation.
Officials from both the health district and the clinic have said the two organizations are separate entities, with separate managing boards and administrations. Clinic officials say they are cooperating with the health district investigation.
There are things that superficially tie the two groups together. According to the Coastal Health & Wellness governing board’s bylaws, the chief executive officer of the Galveston County Health District is an ex-officio, non-voting member of the clinic’s board.
The two groups also work together to create a strategic health plan and to conduct an annual audit, according to the bylaws.
Both the United Board of Health and the clinic’s governing board can nominate people to be on the clinic board.
The two organizations also are housed in the same county complex in Texas City. The Texas City clinic is where officials have the most concern about possible infections.
The Coastal Health & Wellness clinic was previously known as the Galveston County Coordinated Community Clinics, or “4C’s.” The program was renamed in 2012.
PRECEDENT FOR DISTANCE
That the state health agency is leaving the response to a public health concern to the county is normal policy and not without precedent, officials say.
In 2014, in the midst of an Ebola outbreak in Dallas where three people were diagnosed with the virus, it was the Dallas County Health District that led the investigation and response to the outbreak.
The state health agency and the Centers for Disease Control assisted with the response to that crisis.
The Ebola crisis did prompt state and federal hearings about preparedness to address an outbreak, the first of which happened just three days after the first person tested positive for the virus.
WAITING FOR RESULTS
There’s no indication that Galveston County’s incident will prompt as swift a response.
Reached on Tuesday, Texas Sen. Larry Taylor, a Friendswood Republican, said he was aware of the issue and expected state agencies to provide assistance with the response.
“I’m sure Galveston County has the first shot at it,” Taylor said. “It’s too early to know who’s done what.”
State leaders might get involved if there’s “good, actionable action” to take after the investigation is over.
A spokesman for Texas Sen. Charles Schwertner, who chairs the Texas Senate’s Health & Human Services Committee, said there were no immediate plans for any hearings on the Galveston County issue.
That doesn’t preclude future hearings from happening in the future, if they’re warranted after the local investigation is finished, the spokesman said.