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The Northwest Colorado Visiting Nurse Association's community health goals and objectives for 2005 were presented to the Routt County Board of Commissioners on Tuesday.

Sue Birch, executive director for the VNA, told county commissioners that the VNA's three focus areas for this year are the health of mothers and children, bioterrorism and emergency preparedness, and reducing tobacco use.

Birch also told county commissioners that Rio Blanco County has asked the VNA to investigate a possible expansion to include Rio Blanco in its service area. The VNA now covers Routt and Moffat counties.

The VNA is doing a preliminary review of the issue, Birch said, to determine whether there would be any benefits or efficiencies to be gained through such an expansion. However, the issue would have to be approved by the VNA's board of directors and county commissioners before any other steps are taken.

A top focus of the VNA is improving the health of mothers and children. Specifically, VNA officials hope to help increase the low birth weights that are typical for the area, get mothers involved in prenatal care early in a pregnancy, reduce the number of unintended pregnancies and prevent child abuse.

Prenatal care is important for all mothers-to-be, but not all women can afford it. Because of recent changes at the state level, it can take months for some women to receive Medicaid help, even if they qualify, Birch said. That creates situations in which women don't get prenatal care and face problems later in the pregnancy or when they deliver their baby, she said.

In the region, there are 30 to 50 of those situations that VNA follows, Birch said, and there are about 12 in Routt County.

"We're working on the issue. We're chipping away," Birch said.

The VNA is waiting to hear if it will receive a grant to encourage abstinence in teenagers and prevent unintended pregnancies. Also, Birch said VNA officials hope to confront sudden increases in child abuse in Routt and Moffat counties.

Improving on bioterrorism and emergency preparedness means the VNA will work out details of how public health would assist in major emergencies such as outbreaks of illnesses or plane crashes.

Tobacco is one of the major causes of death in the area, so the VNA plans to focus more efforts on education about negative effects of tobacco and preventing tobacco use, Birch said.

To the request from Rio Blanco, VNA responded that its major focus in 2005 and 2006 would on acquiring The Haven Assisted Living Center, but that it would consider the request.

"We've always made it really clear that we can't do anything that would injure our home cities," Birch said.

Routt County Commissioner Doug Monger said he supported the VNA having a conversation about an expansion, but that he hoped that Rio Blanco would not "think they'd get in here and get a pretty free ride."

Birch said that Rio Blanco County had been a "good neighbor" and emphasized discussions were preliminary.

"It's so preliminary that I can't, at this point, make a recommendation to you on which direction we're leaning," she told county commissioners.

-- To reach Susan Cunningham, call 871-4203 or e-mail sbacon@steamboatpilot.com