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Nazareth, Pa., United States

Friday, November 16, 2007

Public Health Getting Contagious in Northampton County

Standing room only!

That was the scene at last night's Northampton County Council, where nearly seventy people crammed into a jury lounge serving as a makeshift meeting room. All the heavies were there, from Bert Daday, on behalf of the aristocratic and normally secretive Lehigh Valley Partnership, to Alan Jennings, on behalf of the CACLV. They were on hand to promote a "Joint Northampton-Lehigh County Department of Health" ordinance.

As Council Prez Grube told them before the meeting ever got under way, they all pretty much wasted a trip. Since the actual public hearing on this ordinance must wait for two weeks, Council Solicitor Lenny Zito suggested they might want to save their best arguments for that day.

Five people spoke anyway.

One of them was LVP honcho Bert Daday, who probably should have listened to Grube. He instructed Northampton County Council that a regional department of health has been one of his group's priorities since 1995. That made council member Ron Angle curious.

"Is your group public or private?"

Daday: "Private. We include 35 CEOs."

"Where do you meet, in some hotel room or something?"

Daday: "We meet quarterly --"

"Are your meetings open to the public?"

Daday: "Our meetings are not open to the public, we're a private organization --"

Lamont McClure came to Daday's rescue with a "point of order" or something before Angle could really get started, and Grube shut Angle down. But I know where Angle was headed. He resents the idea that a bunch of back room aristocrats think they can dictate public policy.

Although I share that resentment, a good idea is still a good idea. And a regional health department is a very good idea, even if it's supported by the Lehigh Valley Partnership.

Dr. David T. Lyon, who chairs the Northampton County Interim Board of Health, drove that point home last night. Here are some of his arguments.

1) Areas with local health departments tend to be healthier.

2) $3.2 million in state taxes paid by Lehigh Valley residents are being used to fund public health elsewhere simply because we lack a health department.

3) A regional approach to public health is economical, provides better access to grants, and will make this area more responsive to public health threats like communicable diseases, that don't stop at county boundaries.

Sounds like a no-brainer. But this is the People's Republic of Northampton County, so stay tuned.

The crowd evaporated as soon as Council Prez Grube said, "First order of business, public hearing on the 2008 real estate tax millage ordinance." At that point, county bean counter Doran Hamann got up and complained, "I thought everyone came for the budget hearing."

Later that night, as council churned through tax abatement ordinances, Angle was still undecided over the notion of a regional health department. Finally, he asked Stoffa whether he supported the idea.

Stoffa: "Yes, very much."

"Can we get together sometime in the next two weeks?"

Stoffa: "If you promise to listen."
Update: The Morning Call's Joe Nixon provides the background leading up to last night's pproposal, and The Express Times' Sarah Cassi notes that some complain there are unanswered questions.


Anonymous said...

just so everyone understands:

it will cost money.

michael molovinsky said...

in allentown, under an ambitious dept. head, the health department rose to 45 employee's. when the sacred heart hospital opened a large low-income health center duplicating most of the services, the city health czar declined to downsize. at one point allentown was actually providing services to the coal regions. as judge young pointed out, non-profit lehigh valley hospital made 80million profit last year; this year they proudly reduced their windfall by providing more "community aid". regional health care sounds rational and compassionate, but there might be more efficient taxpayer friendly solutions.(in kind service from cash cow non-profits)

Anonymous said...

Even if the Counties pass this thing, if they cannot get Bethlehem and Allentown to agree to it, then I doubt it will happen.

Bethlehem Councilmen have said they will only approve Bethlehem's participation in the Regional Health Bureas if Bethlehem residents do not see a fall off in the services they are currently provided. They also do not want City residents subsidizing a health bureau for the townships.

As many know, Bethlehem's Health Bureau is one of the premier health bureaus in the state.

This was a question that came up at the "debate" held by the League of Women Voters last month.

Bernie O'Hare said...

Anon 7:42, Yu are right. Unless Bethlehem and Allentown agree, there will be no regional health department. I know Bethlhem has already said it will only agree to this if there is no diminution in health services to its city residents. So the model being considered leaves both of those intact and proposes incremental additions into surrounding areas over time.

Bernie O'Hare said...

MM, Actually, the hospitals are behind the notion of a regional health department. Now Angle wants them to kick in some money, too, which only makes sense because a public health department relieves the burden on them.

You say there might be a more efficient and taxpayer friendly solution. I'm listening.

One of the pluses of a regional department is it will be efficient. Another is that you'll maximize your ability to get grants. Inm fact, even though there is no health commission, the Poole trust and Two Rivers health Foundation have already kicked in $1MM in seed money.

Bernie O'Hare said...

Anon 5:38, You're probably right. Under the model proposed, the annual cost of a regional health department is $7.2 MM (staff cost and operations). The revenue generated would be as follows:

Act 315 - $2.21 MM
Act 12 - $0.9 MM
Grants - $2.0 MM
Fees = $0.75 MM
Public - $0.66 MM
Private- $0.8 MM

Total revenue - $7.32 MM

Presumably, taxpayers will be relied on for the $660,000 in public support, spread out over two counties. I think the private support, which presumably comes from local hospitals, is too low, and would like to see a bigger committment from local hospitals. But those are the numbers as they stand for a very basic LV health department.

Tom Foolery said...

I hate to say this but Angle is right. The county cannot afford a health department. No matter how many grants come flying in initially it will still end up costing millions. Why even tackle it. Let the gambling money go to human services where it belongs. I don't care what all of the supposed know it alls say (especially the Call) it is not needed and the county has many more priorities!!

Bernie O'Hare said...

Tom Foolery,

You can see the comment above to get some details about cost. Angle was suspicious about that, too. If you combine AHB & BHB, you have 72 people. Yet the proposed start up staff for a regional health department is only 96.5. That brought about an interesting exchange between Dr. Lyon and your idol, Ron. Angle expressed some skepticism over those numbers, suggesting the department would be much bigger. Dr. Lyon said that "experts" in public health had reviewed them and they were good numbers. Angle replied that he's an expert in government and those numbers are bound to be bigger.

This will eventually end up costing us money, but how much depends on how good we are at leaning on private funding sources, and they need to be leaned on.

But I support the idea and even the idea of a public contribution because in my view, that's why government exists. Right now, wee're overdue for one of those cyclical pandemics. A public health department is probably the best way to minimize the damage it will do.

I agree the county has other priorities, especially the prison and doing something about voting machines. But this should be a priority, too. The MC, ET and even the LVP are right on this one, at least in my view.

I believe this is one of those rare instances in which political philosophy actually does have a lot to do with a local issue. I would expect conservatives to question this, not only because of the cost, but because it is another layer of government bureaucracy. I'd expect liberals would tend to support it, because it improves the quality of our lives, and that's why government exists.

Anonymous said...

Are "back room aristocrats" inherently evil? I read the snark, but, alas, found only evidence of their support of a worthwhile initiative.

Bernie, did Daday arrive in a customary black helicopter? What are his true, aristocratic intentions?

Broad brush strokes tend to betray society's "ists" (racists, sexists, and yes, wealthists) in stark relief.

I'm glad to live in a country that guarantees the right of association with private groups. I prefer to judge all individuals individually, regardless of their race, sex, ethnicity, or bank account balance.

Tom Foolery said...

11You make a good argument. However I don't trust government. I think , as Angle does, that it will be a trojan horse. Bring it inside the walls and it will become an expensive proposition. Aside from this, where is the great need. Outside of the aristocrats, who has been calling for this? Certainly haven't heard the people in the County clamoring for this..Grube has always been a people person. Hopefully he understands this too.

Tom Foolery said...

Besides, Bethlehem would be foolish to join the County department. They are being well served now..There is no way they will do better with the county. Hopefully, MCcale understands this. Being a Bethlehem rep she needs to consider this..

Bernie O'Hare said...

Anon 9:30 AM, Are "back room aristocrats" inherently evil?

In a word, yes.

I confess a healthy distrust of wealthy consortiums that decide what's best for the rest of us behind closed doors.

We had a revolutionary war to settle that question, as you may recall.

Daday has as much right to speak as anyone else. In this case, his group's position happens to coincide with what I think is a good idea. But I hope you'll pardon my suspicion of any altruistic motives.

Bernie O'Hare said...

Tom Foolery,

What is being proposed is the establishment of a health commission, not the funding of one. That's down the road. I see no problem with taking a baby step forward and then seeing how this thing looks when it goes from nebulous proposal to concrete idea. If we don't like it, pull the plug.

In addition to Angle, Grube is dubious. McHale, as I'm sure you know, will fight tooth and nail against anything that hurts Bethlehem.

But I wouldn't kill the idea just because it might bnecome a white elephant. Why not take it to the next level and see what the hard numbers are?

Tom Foolery said...

I know what you are saying makes sense but as I mentioned in the Trojan Horse analogy once it gets inside the walls or eevn closer to the gate we need to start sweating..

Bernie O'Hare said...

Tom Foolery,

I understand your concerns and they are very real. I'd support the formation of a commission, but would not agree to empower it without a lot more detail to answer your objections.

So when are you and Ron getting married?

michael molovinsky said...

bernie, my proposal is that the hospitals provide and pay for the bureau. when i say LVH made 80mil profit, that was after every possible deduction imaginable. Add the profit from St. Lukes and Sacred Heart, deduct the tax free real estate valuation they enjoy, and it would be an affordable in kind service they could farther deduct. If and when disaster or pandemic strikes, we will be dependent upon their coordination(hospitals), this would provide a good framework for that objective

Bernie O'Hare said...


That's a good suggestion. A public health buireau will lessen the burden on local hospitals, so they should be expected to kick in far more than $800k.

Tom Foolery said...

We are already married...By the way, one more thing. I believe Bethlehem's administration would love to dump the health department on the County. It would not be in the best interests of their residents but it would save them money. Cunningham started this process in 2002 or 2003 by beginning to dismantle bethlehem's department with cuts. I think he was hoping the county would eventually pick up the responsibilities. They have not as yet. Hopefully , they won't..

Larry Kisslinger said...

I agree with michael molovinsky, BO, tom foolery and some others here. LV needs to "share" responsibities for the public good, especially health issues.

Seems Bethlehem current health
services only need to be used as a standard to replicate services as most here suggest is well delivered!

Maybe an "Authority" would be better than a Commission? Recall recent water/sewer services tooth pulling to provides services in Bethlehem Township and elsewhere! Bethlehem City agreed early on to provide water/sewer services to a number of communities and we've been dealing/arguing with all involved communities ever since I suggested "should have been" overseen by County or State and not Bethlehem alone.

No LV community should have to be providing services to others w/o proper compensation for any such services, or always arguing who has to pay. Further, specific formula has to be legislated to provide for any such services, in my opinion. LVP and other private, all hospitals, health care providers, and taxpayers need to "kick-in" proportionately if is ever going to work. No lawsuits, threats of lawsuits, negotiations
and the like should ever be part of the equation, henceforth. What part of the importance of public health services in entire LV don't we understand?larry@kisslinger.com old recycled public official.

Anonymous said...

Larry Kisslinger said... Maybe an "Authority" would be better than a Commission? Recall recent water/sewer services tooth pulling to provides services in Bethlehem Township and elsewhere! Bethlehem City agreed early on to provide water/sewer services to a number of communities and we've been dealing/arguing with all involved communities ever since I suggested "should have been" overseen by County or State and not Bethlehem alone.
When did Larry Kisslinger become the Bethlehem Water Authority? The water is Bethlehem's not the state or the county. Your in over your head Larry, hold your breath, you're going under or don't you drink water?

Lady Rep said...

Personally, I am always nervous when it comes to enlarging ANY government beaurocracy. If the city bureaus are working, let them go. If they're not, making them part of a bigger entity will only exacerbate the problems. Could the hospitals provide more clinic centers (and relieve some of the "emergency room as family doctor" traffic as well) with their profit and coordinate with government (through grants, etc...)for anything that would be an extraordinary public health issue? I'm just asking the question. A coordination plan with the county could be in place for anything that is beyond the normal realm.
Once a government entity is in place, I've never seen one downsized or eliminated yet. I'd rather see the free market in play as opposed to leading us down the road to socialism. Bigger ain't always better!
By the way, Bernie, respectfully, I hope that I am responsible for the quality of my life, never the government. I just want them to provide a safe enviroment for me to run my own life as well as I possibly can.

Bernie O'Hare said...

Lady Rep,

I appreciate and respect your point of view. I'd agree that government tends to grow, not shrink.

I think government's basic role is to improve the quality of our lives. Others, like you, resist governmental intrusion into their daily lives and believe you should be able to run your own life.

It's probably the basic difference between conservatism and liberalism. Neither one of us is ever completely right or wrong.

Your point about hospitals is a good one and I don't have an answer.

Lady Rep said...

Bernie, your discourse is why you have such a good blog and why I appreciate it. Get that critter who is impersonating you!

Larry Kisslinger said...

Anonymous 11:38 PM said...
Larry Kisslinger said... Maybe an "Authority" would be better than a Commission? Recall recent water/sewer services tooth pulling to provides services in Bethlehem Township and elsewhere! Bethlehem City agreed early on to provide water/sewer services to a number of communities and we've been dealing/arguing with all involved communities ever since I suggested "should have been" overseen by County or State and not Bethlehem alone.

When did Larry Kisslinger become the Bethlehem Water Authority? The water is Bethlehem's not the state or the county. Your in over your head Larry, hold your breath, you're going under or don't you drink water?

Hey numbskull, it should be you're not your...holding my breath, not drinking water makes no sense to me, same as the rest of your nonsensical comments.

Also, number one there is no such thing as a "Bethlehem Water Authority"! It is simply known as Bethlehem Authority if you need to be educated as it seems so! I agree Bethlehem owns the watershed at Wild Creek through the vision of Engineer Fox and other Fathers of my fair City with vision you can't imagine, I'm certain! Also, the Sewage treatment plant off Applebutter Road in Bethlehem is part of the operation. Why must Bethlehem take charge of all that takes place forevermore without proper compensation from all users, is all I suggested.

How can I debate this issue with an Anon? I beg you to come out of hiding and debate me further anytime, anywhere you so desire and you might learn something you never knew. ask any media and elected officials to cover any such event is fine with me! Do you accept the challenge, chickenshit?
Lastly, what do your comments have to do with health care topic here? larry@kisslinger.com