January 19, 2010
For the past two decades, Lehigh County officials have sought a county-wide or regional health department. In Pennsylvania, cities often have health boards while the suburbs rely upon the state for very limited coverage. In Lehigh County, while the cities of Allentown and Bethlehem have health departments, the other municipalities rely upon state enforcement, if any, for health issues ranging from the inspection of public establishments to the response to pandemics, natural disasters and even bioterrorism.
The old model may have worked at a time when restaurants and hotels were located within the cities and when the townships housed farms and rural business. Today, you are far more likely to dine outside of the city limits as you are to eat within Allentown. There can be a great difference in enforcement standards depending upon the side of the street a business is on—whether it is in the city or not.
With concerns over H1N1 and before it the Avian Flu, there are big issues over how government can respond in the case of a public outbreak. Without local health departments to marshal resources, you may need to rely upon a response from Harrisburg.
Lehigh County made great strides forward over a year ago when it established a joint board with Northampton County tasked with establishing a two-county, regional health board. Now, a year after starting the joint undertaking and several years after starting the initial efforts, the future of the proposed Lehigh Valley regional health department remains uncertain at best.
When representatives from the Lehigh County Board of Commissioners and the Northampton County Council met on Jan. 11 in a somewhat contentious meeting, the best news coming from the meeting was that the measure was not killed. The two legislative bodies are tasked with establishing the health department in these joint meetings and they are far from being in lock step.
To date, the support of Northampton County has been less than that of Lehigh County. Even in Lehigh County, newly-elected commissioner Tom Creighton was a vocal opponent of the plans for another government agency. One has to think Tom will come around with education and background in the matter. Northampton is another matter as they have had strong opposition from the beginning.
Commissioner Dean Browning was criticized in the press for calling for a vote at the Jan. 11 meeting. Had a vote been taken, even proponent Percy Dougherty agrees that Northampton would have opted out. Truth is that is the very reason why a vote should have been taken.
Dean Browning wrote in an e-mail to the Morning Call “I read your column about the health bureau in today’s paper and wanted to respond as to why I felt a vote was appropriate at the last meeting. As background, my count of noses shows that there is support from a majority of my colleagues on the Lehigh County Board of Commissioners to proceed with the health bureau. I have not reached an opinion but prefer to wait until the budget and operational model is presented in April. However, my strong sense is that Northampton County will pull out at that time, regardless of what is presented by Dr. Lyon. Should that occur then the time, effort and expense devoted to preparing a budget and operational model based on participation by both counties would be for naught. That would then require Dr. Lyon and his board to take a step back and reformulate a plan based on a Lehigh County only model. While this might not be a major task at that point, it certainly would involve some expense and, more importantly, would result in a time delay in reaching a decision to implement the health bureau. Simply put, my thought was that if Northampton County is going to pull out regardless, wouldn’t we be better served knowing that fact now rather than 3 months from now? “
Northampton is as likely to say no as they are to approve the joint agency in April. For those who believe that a county health department makes sense, the way forward is to produce a budget for a Lehigh County Health Department that can either stand on its own or fail on its own. By a quirk of law, Bethlehem, which most think of as Northampton County, is partly in both counties and could be made part of the Lehigh County Health Department.
Rather than more delay waiting for Northampton and for the “role model” of a bi-county agency, the time is now to get the Lehigh County Health Department up and running. Let Northampton later decide if they want in to the agency.
The appointed provisional health board which is designing the health department for approval by the two counties “was given until April to come back with a very in-depth budget.” That budget is still for a bi-county agency. Even if the budget shows the agency works, the Northampton buy-in is uncertain. If Northampton balks, as expected, it will be back to the drawing board, so why not go for the sure thing now. Had Northampton killed the concept last week, Lehigh County could be moving forward rather than wasting time.
Lehigh County Commissioner Percy Dougherty said that more financial projections were needed. “No one has enough information to vote it up or down,” he opined. “We have no idea on the costs, whether they are a quarter of a million dollars, $2 million, or nothing.” Some of the initial funding, at least, comes from private and foundation sources. The financials are “the key piece of the puzzle” according to Dougherty.
The financial projections in April, therefore, will determine not only if Northampton County decides to join in the effort but also if Lehigh County is willing to go forward without them.
Lehigh County Commissioner Andy Roman is a strong supporter of the concept. In the interest of “healthy debate,” he sent an e-mail to his colleagues after the meeting which suggests that cost is a secondary issue to the need for the agency and its value.
“A modern Health Department would be a strong guardian of protection for the residents of the Lehigh Valley,” Roman wrote, “This isn't Mayberry. The Lehigh Valley is the 3rd largest metropolitan area in PA.”