Tuesday, July 20, 2010

Lack of Hospital Support Kills LV Health Board

Despite over four hours of emergency medical treatment from the Lehigh Valley's best and brightest physicians and nurses, the Lehigh Valley Health Department died a slow and agonizing death last night in Northampton County's star chamber. Quoting FDR, JFK, Thomas Jefferson and even Ben Franklin proved to be of no use. Time of death? 10:38 PM. Cause? Lack of hospital support.

Before last night's vote by the combined legislatures of Lehigh and Northampton County, enough hot air was generated by public health and personal responsibility advocates to heat the County for the next five years. Twenty-nine people spoke to a standing-room only crowd, and twenty-two of them supported the measure.

Public Health Advocates v. Personal Responsibility Advocates

"It's time for a change," said dietitian Jane Ziegler, wearing her white lab coat for effect. Retired surgeon Michael Sinclair called the proposal "creative" and "brilliant." "Good bargains are hard to find," he said. Auto dealer Andy Daub tried to close the sale, calling a bi-county health department an "investment" that will somehow decrease the cost of health care. "We've got to compete with Bucks County or we're not going to get the jobs. ... They're gonna' walk right by us."

But the high local cost of Bucks County's health department, estimated at somewhere between $4 and $6 million, was used by personal responsibility advocates to argue against a bi-county health department. Former LV Congressional candidate Mat Benol told Lehigh and Northampton County legislators that "no amount of money is going to make people stop going to McDonalds."

Scrappleface, aka former LC Exec candidate Scott Ott, scoffed at the notion that a bi-County health department would be cost efficient. "You have to ask yourself, if two counties are good, why isn't four counties better? If four counties would be better, why not a twelve-county coalition? If a twelve-county coalition makes sense, how about a sixty-seven county coalition? Because certainly, the higher we roll this up and the more regional coordination we have, the better the care would get, or so you've been led to believe. So why not have Governor Rendell coordinate everything from Harrisburg, or President Obama coordinate it from Washington, D.C." He later said, "You don't have to rescue us. ... You cannot solve every problem."

We're Too Fat and Our Babies are Too Skinny

After hearing from the unwashed masses, the next people up were LV Health Board members.

Dr. Eric Gertner explained why we need public health. For one thing, we're too fat. In Northampton County, 30% of us are obese, and Lehigh County is only slightly skinnier, at 26%. If Northampton County were a state, the only ones that would be fatter than us would be Mississippi, Alabamy, West Virginy and Tennessee. It's like we're in Deliverance country. The truth is that Northampton County's obesity rate would go down ten points if I just moved.

While we're too fat, our babies are too skinny. 8.3% of Northampton's babies have a low birth rate, while Lehigh County is even worse, at 8.7%. Even Mongolia does better than us. But don't Mongols have anger issues?

John Reinhart, another Board of Health member, explained the nightmare he went through when he had to distribute H1N1 vaccines at the Bangor School District. "There seems to be a comfortable belief that we in the LV will be taken care of by some agency or some group, and that agency or group will not permit us to be vulnerable during a public health crisis. I personally believe that's clearly a misconception. ... We reached out last Fall during H1N1, and with the exception of Allentown and Bethlehem, there really wasn't another person on the end of the line for the rest of us."

Health Board member Ilene Prokup told legislators of plans for 5 clinics in Allentown, Slatington, Bethlehem, Easton and Bangor. She also said the staff would grow from 66 to 106 in the first year.

Lehigh and Northampton County legislators had several objections.

Bruce Gilbert (North.) was doubtful about the 3% projected annual growth, believing the figure will be much higher as a regional health board competes for grants with Philly and Pittsburgh. "I don't see that as a realistic figure as to what our cost increase will be. I'm not sure we're getting an accurate picture ... ."

Glenn Eckhart (Leh.) noted that 66 public health workers currently serve 175,000 people in Allentown and Bethlehem, and was very doubtful that an additional 50 workers could serve 600,000 residents in the LV. "Will this health department give equal coverage to the other 400,000? Until that happens, I can't support it."

The Northampton County Bulldog, Ron Angle, was in a foul mood. Chairman Percy Dougherty had started the meeting by saying any attempts to table the LV Health Department would be out of order, and he reached that conclusion on the basis of discussions with attorneys from both Counties. Angle asked County Council Solicitor Phil Lauer whether that was true, and Phil responded, "This is the first I've heard of it." Dougherty got his signals crossed somewhere.

Angle's chief objection (he had a few) is that Allentown and Bethlehem are guaranteed they will receive the same services from a Bi-County Health department that residents there currently enjoy. "This is a two-tiered service. If we vote against increases, Allentown and Bethlehem will still get the same service and everyone else will suffer." He also ridiculed the numbers in the proposal, calling them "pitiful."

Lamont McClure (North.) delivered the most damaging assessment. He had previously boycotted all meetings concerning the establishment of a Bi-County Health Department, and noted that "we've been lectured about our responsibilities", "our failure to provide for public health." Then he delivered a lecture of his own, telling health board members that the County's source of revenue is real estate taxes. "There is a crisis in Pennsylvania, but it is of people trying to stay in their homes." He noted many good people are just "one pink slip away from foreclosure," and read minutes from previous presentations establishing that local hospitals want public health so they can get people out of their emergency rooms.

McClure wanted to know if hospitals were willing to fund the County share for the next five years. Board member David Beckwith conceded that, although hospitals were more than willing to provide in-kind services, they will make no cash contributions.

This seemed to set off the normally affable Dean Browning (Leh.), who agreed with McClure that "we have been somewhat lectured to tonight." Of the hospitals' refusal to commit any cash, he stated, "They damn well should support us because they are not paying any property taxes." Browning noted that, in Lehigh County, hospitals are exempt from $8.1 million in real estate taxes. "If they want a Bi-County Health Department, they should put their money where their mouth is and fund it."

Mike Dowd (North.) noted that satellite offices would be established "when deemed appropriate," and questioned why that was not already determined. He shared Angle's concern about funding for Allentown and Bethlehem leading to shortfalls elsewhere. Finally, he'd like to see proof of the "salubrious benefit" of public health to students in Allentown and Bethlehem. (Mike talks like that. He reads books).

In addition to all these objections, there were other legislators who argued in support of funding a Bi-County Health Board.

Andy Roman (Leh.) trotted out the "Be afraid, be very afraid" argument, pointing to 9/11, bio-terrorism and our drinking supply. He also noted "we are already paying for services that we're not receiving from a system that is fragmented and has no local control. Conservatives should support this."

Gloria Hamm (Leh.), who had oxygen going up her nose the entire meeting, must have had her supply cut off by Angle at points. She was hopelessly confused before every vote cast, but dismissed the personal responsibility argument as some kind of red herring. She also noted that if one grant is denied, the health board can simply apply for another one somewhere else. I see.

David Jones (Leh.), who actually showed up for once, claimed he was no politician, but was a preacher. He condemned the "rhetoric" and "grandstanding" that had gone on "from both sides" and then delivered a sermon of his own. Arguments against the health board were "strawmans" [sic]. Those opposed are guilty of "unreasoned fear." Then he quoted from FDR, Martin Luther King and Adam Sandler.

According to Bill Hansell (Leh.), funding is imperative. "Listening to the opposition, I'm wondering what country we're in." Then he started quoting Jefferson, who incidentally helped Hansell draft the Declaration of Independence. By the way, I hate to break this to you, but according to Hansell, the health board report claims "we have cancer." Better see your doctor. He also insisted public health should be our #1 priority, more important than open space, bridges or even jails.

Percy Dougherty (Leh.) promises, "we're not going to saddle the taxpayers" with the cost of a health board, and claims he could transfer funds from "other programs." But he never identifies those programs.

Ann McHale (North.) had the usual trite comments. "Now is the time to make the tough choice. ... It's the right thing to do. ... It takes courage to do the right thing ... blah, blah, blah." I'm sure her Overlords at the Lehigh Valley Partnership were very happy.

Despite Dougherty's admonition earlier that evening, Angle moved to table the resolution for two weeks, pending receipt of a report on the County's nursing home. He was seconded by Dowd, who expressed concern about Northampton County's $16 million hole. But that motion failed. An attempt to offer amendments to the Resolution also fell short. That left the Resolution itself, which authorized funding, approved a budget and authorized establishment of a Board of Health. In order to pass, this resolution needed the support of five members of both Lehigh County's Board of Commissioners as well as Northampton County Council.

When the dust had settled, it passed in Lehigh County, 6-3. Only Browning, Tom Creighton and Eckhart were opposed. But it failed in Northampton County, 2-6. Only McHale and Peg Ferraro voted yes, with Tom Dietrich being the only member MIA from both legislative bodies.

What killed this proposal, in addition to poor advocacy and a condescending attitude from public health advocates, was the unwillingness of local hospitals to provide any kind of financial support for a program that benefits them at least as much as the public.

Funeral arrangements will be handled by David Jones' Life Church.

53 comments:

Anonymous said...

Caught some of the action on the web. I almost did a backflip listening to the businessmen and Camber types talk about the need and right and obligation of basic health care.

When Andy Daub spoke I thought I was listening to Barack Obama. Speaking of which Daub and the other businessmen and the Chamber showed what complete hypocrites they are.

They mocked, attacked and made basic health-care coverage in a National Plan sound like the second coming of Lenin, yet somehow the same same plan handled by the Counties would be a wonderful thing.

Hypocrites, bullshitters and con-artists. Those are the nicest things I can think of for Mr. Daub et al.

I supported National Public Health yet I have more respect for the tea Party folks whom I disagree with but showed more integrity and consistency on this issue than the Chamber and the business community.

A Blast from the Past

Anonymous said...

It basically failed because the plan was built on sandy ground and empty promises.

Anonymous said...

Thank heaven this turkey is dead. Great reporting Bernie. By the way, I am afraid, very afraid of expanding,ever more intrusive, and costly government.

Scott Armstrong

Anonymous said...

this white elephant was dying from the start. the only thing that kept it alive was BS and bleeding heart liberal hot air. may it not rest in peace

Anonymous said...

Did any one notice the biggest lack of hospital support? David Lyons NOT ONCE spoke up about what support Easton Hospital planned to give. The monies Twin Rivers was going to give was left over money from the sale of Easton Hospital to the Tennesse company- when that money was gone, it was gone.

Anonymous said...

both hamm and mchale are in never never land with their comments. must have been sniffing too much silly putty

Anonymous said...

2 points BO. your coverage of this "event" is much better than either the MC or ET. good job

Anonymous said...

Is David Jones a self-appointed preacher? We ask, because after reading this blog the past year,
his persistent absences from his pledge to represent Lehigh County residents via the County Commissioner seat he won indicates an arrogance and disregard for
people that is hardly a preacher's pattern of behavior.

Anonymous said...

If 66 Lehigh County Health Bureau employees can't curtail the obseity rates, no one can.

Anonymous said...

Anonymous said...

2 points BO. your coverage of this "event" is much better than either the MC or ET. good job

7:05 AM

Ditto

Anonymous said...

It would be interesting to learn if Brown-Daub provides and has provided health care for its employees.

Anonymous said...

I have a car salesman friend who finally had to leave because the Daub owned dealership he worked at kept changing the commission rules and making it impossible to earn a living, while the big dog kept on keeping on.

He knows all about telling everyone else to sacrifice, apparently.

LVCI said...

From what I understand the hospitals cannot contribute to this because the Health Board would be ineligible for the state and federal funding.

That said I am very clear why the Hospitals would just love for this to have gone through. They'd have to be crazy not to. So anyone connected with them supporting this would be been a lobbyist (because of self interests).. to my way of thinking.

Anonymous said...

OK Bernie.The Morning call article sucked today..Couldn't understand if this monster died or is still on life support..Is it dead or is it just shelved for now? What's up?

Anonymous said...

The Call said that to kill the monster one of the counties has to vote to do so at a separate meeting..Hopefully Northampton county acts soon to do this..This monster would be questionable in good times, however now, when they talk about County layoffs and cutting county employee salaries this would be abvsolutely nuts..Three cheers for all who voted it sown last night..Now let's kill the monster once and for all before it comes back to life..No moratoriums, no life support..Kill it now or it will haunt you forever!!!

Anonymous said...

Great Picture Bernie!

Anonymous said...

Great Picture Bernie!

Anonymous said...

If we had universal healthcare like the rest of the industrialized world, this wouldn't even be a conversation.

Anonymous said...

So, did our local legislater Thomas Creighton have anything to say?

Bernie O'Hare said...

Creighton was mercifully quiet, and in my opinion, that's a pretty good quality.

Bernie O'Hare said...

"If we had universal healthcare like the rest of the industrialized world, this wouldn't even be a conversation."

It would still be a conversation. Universal health care and public health are two completely different concepts.

Bernie O'Hare said...

"The Call said that to kill the monster one of the counties has to vote to do so at a separate meeting..Hopefully Northampton county acts soon to do this.."

For practical purposes, it's dead now. It is not on life support. The life support has been taken away. Angle stated an ordinance will be introduced to formally kill it, possibly as soon as next Council meeting.

Bernie O'Hare said...

"Couldn't understand if this monster died or is still on life support..Is it dead or is it just shelved for now? What's up?"

So here's the deal. technically, it is still alive, but it is actually off life support. Last night, the plug was pulled. The LV Health Board has no money to ddo anything and has not been authorized to act in any way.

But it can only be technically killed when one of the counties withdraws its suport at a separate meeting. Expect to see that at a NC Council meeting soon.

Bernie O'Hare said...

"the hospitals cannot contribute to this because the Health Board would be ineligible for the state and federal funding."

LVCI, that is incorrect. You are confusing hospitals with foundations like the Poole trust. Hospitals are already making in-kinds. Hopsitals were approached for cash contributions and flatly said NO, in a myopic decision that sounds the death knell for LV public health.

Anonymous said...

The NC rubes strike again. Who needs health when you have a few extra dimes to buy Big Macs?

Bernie O'Hare said...

"Is David Jones a self-appointed preacher?"

Depending on where he is, Jines makes different claims. Last night, he claimed to be a preacher. I've also heard him claim to be a hard-headed businessman. I actually consider him little more than a snake oil salesman.

Anonymous said...

Think of this moment next time you need to go to the emergency room and have to wait behind 20 people with colds and earaches.

Bernie O'Hare said...

That's the most ridiculous justification for another layer of bureaucracy I've heard to date.

Bernie O'Hare said...

"Who needs health when you have a few extra dimes to buy Big Macs?

I can see the stunning success rate in Bethlehem and Allentown, which have their own health departments.

Bernie O'Hare said...

"I supported National Public Health yet I have more respect for the tea Party folks whom I disagree with but showed more integrity and consistency on this issue than the Chamber and the business community."

Agreed. I was impressed by Mat Benol, Scott Ott and others who acvtually came and spoke last night.

Bernie O'Hare said...

I was also impressed by some of the supporters.

It was a nice exercise in democracy.

LVCI said...

I said, ""the hospitals cannot contribute to this because the Health Board would be ineligible for the state and federal funding."

Bernie Said, "LVCI, that is incorrect. You are confusing hospitals with foundations like the Poole trust.

According to Easton Express: -
"counties cannot use in-kind services from area hospitals to help the proposed health department qualify for state grants.

Contributions of money or services from Lehigh Valley Health Network and St. Luke’s Hospital would be considered gifts, according to a May 18 letter from the state Department of Health, and cannot be used toward local funds necessary to match state funding.

Instead, Lehigh and Northampton counties would need to come up with the matching funds themselves.
"

So I my statement regarding federal funding may possibly be incorrect??? But as far as the state was concerned (according to the article).. nada

Bernie O'Hare said...

LVCI,

Thank you for your links.

In-kind services, which were clearly contemplated for matching purposes, could not be used for state-matching purposes. Direct cash contributions would fail, too. But there are ways the local hospitals could have made cash contributions to other entities that would still qualify for matching purposes, as I understand things. For example, they could have funneled money thru United Way.

If you were correct, Dr. Beckwith or others on the Board would have raised that flag right away when McClue made his proposal. Instead, they made overtures to the hospitals and were rejected out of hand.

Anonymous said...

Could care less whether this passes or not, but I agree with a previous poster. Outstanding recap and coverage.

Anonymous said...

This idea needs to die quickly..Hopefully you are correct and Angle will give it the final blow at the next Council meeting..I love when the proponents go on and moan about killing this boondoggle. They say we spent so much studying it we should just continue wasting more money keeping it alive..bad idea!!
Kill this thing already and move on!! It makes no sense at all..Of course the king of spending government money, Alan Jennings was there..maybe he figures he can pick up a few more bucks to waste..What a joke! Off with its head already!!

Anonymous said...

Bernie - I normally don't post but I had such a good laugh and had to let you know after I read your comment about Dowd:

"Finally, he'd like to see proof of the "salubrious benefit" of public health to students in Allentown and Bethlehem. (Mike talks like that. He reads books)."

He reads books....that's great, absolutely hilarious!!!

Chris Casey said...

I have to wonder....
St. Luke's and LVHHN have both spent gazillions in the past decade to expand and improve services. If the health bureau would be so wonderful, why don't they do it on their own? It's not like they don't have the money, because they do. Sacred Heart in downtown Allentown is on life support as it is, LVHHN has some loose affiliations going to keep it afloat. Ever wonder why when someone gets shot at 5th and Linden they roll them all the way to Cedar Crest?
Food for thought.

Beata B said...

"But there are ways the local hospitals could have made cash contributions to other entities that would still qualify for matching purposes, as I understand things. For example, they could have funneled money thru United Way.

If you were correct, Dr. Beckwith or others on the Board would have raised that flag right away when McClue made his proposal. Instead, they made overtures to the hospitals and were rejected out of hand."

Bernie -- as someone who was involved with this, I can tell you that this is not true. Cash contributions through the hospitals could not qualify as local matching funds, even if funneled through United Way (or some other organization). They could be a match if the hospital funds were given to, say, the counties' general fund and the counties then decided to use that money for the health department. But, of course, once funds are in the general fund, there would be no guarantee that they would be used for the health department.

The local match that is required for the establishment of an Act 315 (state-approved) department must be public, texpayer money.

I'm not sure why Dr. Beckwith and others did not raise that flag at last night's meeting -- though I imagine a strong sense of fatigue had something to do with this. I'm surprised that many people managed to stay up for the duration of this meeting. I almost fell asleep in my chair.

Regardless of the outcome, thank you for covering it last night, Bernie.

Anonymous said...

"Ever wonder why when someone gets shot at 5th and Linden they roll them all the way to Cedar Crest?"

Um, because LVHHN is a trauma center and Sacred Heart isn't.

Anonymous said...

That's the most ridiculous justification for another layer of bureaucracy I've heard to date.

Fixing our broken system is "ridiculous?" Cut taxes and let all other societal problems be damned! I guess someday your health will catch up with you too and your ignorance will be brought to the fore.

Anonymous said...

Um, because LVHHN is a trauma center and Sacred Heart isn't.

LOL. Misinformation runs rampant on this blog.

Bernie O'Hare said...

BeataB74,

Thanks for your comment. I'm sorry I did not come over to say Hi to you and Steve last night. My understanding is that cash contributions would still count if funneled thru a third party, but I bow to your superior knowledge on this point.

Besides, you have made the point that hospital grants would qualify for state matching funds if the funds went directly to the County instead of the Health Board.

There might be no guarantee but the County would be committing to the budget of the Health Board, so this is no insurmountable obstacle.

You almost fell asleep in your chair? No wonder Stoffa kept inching over towards you. Watch him. ActuaLLY, I was up until 3:30 AM writing about the meeting. I'm pretty tired nyself right now and am swilling gallons of coffee.

Anonymous said...

This discussion about the spaghetti of laws and jurisdictions to be resolved confirms that it's a bureaucratic mess that proponents wish to solve with still more bureaucracy. Einstein's definition of insanity comes to mind. I say we provide comfort for the ailing by heating their houses by burning taxpayer dollars in those little Amish stoves. My solution is more effective, more clearly defined, and less expensive.

Wayne said...

Anonymous said...
Think of this moment next time you need to go to the emergency room and have to wait behind 20 people with colds and earaches.

10:31 AM
-----------------------------------

When I go into an emergency room I am usually clutching a bloody rag around my hand and with a desperate look in my eyes... right to the front of the line I go!

Anonymous said...

To 3:09 PM from 3:04 PM

What is so funny about my answer? There's no misinformation about my answer. Both LVHHN and St. Lukes are Level 1 Adult trauma centers. There are currently 32 accreditated trauma centers in Pennsylvania by the PA Trauma Systems Foundation. Sacred Heart is NOT a trauma center. There are 11 Adult Level I trauma centers, 11 Adult Level II trauma centers, 1 Adult Level I/Pediatric Level I trauma center, 2 Adult Level I/Pediatric Level II trauma centers and 3 Pediatric Level I trauma centers. Chris Casey wanted to know why they drag people all the way to Cedar Crest instead of Sacred Heart. Now you know the reason why, too. Next time, know the facts before you shoot yourself in the foot and spout off on something you don't know anything about.

Wayne said...

You really had to be there to get the full effect. During the comment section the need for the health board was so over-sold that I think it hurt their case.

Health boards were touted as invaluable in stopping smoking, drug addiction, STD's, overeating, etc, through education. Bicyclists will wear their helmets where there are health boards and cars will respect pedestrian crosswalks. I'm not kidding with that last one, the lady was serious!

The poor Slate Belt was portrayed as a festering hotbed of disease and ignorance. And they come down into the rest of the county and mingle with the rest of us!

If they would have focused more on the need for a clinic & aid assistance office in the upper-half of the county they might have had more sympathy. IMHO

The confusion over the voting was priceless. I swear on certain council members you could see the realization of what was going on slowly appear on their faces. Ron proposing that it be tabled was giving them an opportunity to possibly win some other day. But they were so eager to pass it, "Now is the time to act"... but apparently nobody bothered to count to see if they had the votes.

Definitely worth the price of admission.

Bernie O'Hare said...

Good summary. You're right. The pedestrian argument was nonsense. I just loved the we need restaurant inspections bc sometimes we have to eat with the poor people from Bangor and I guess they're dirty.

Anonymous said...

Best way to clear the ER and get quick service is to wear any article of clothing that says INS, ICE, or IMMIGRATION. Seriously, it works.

Anonymous said...

Who voted for the Board in Northampton County?

Bernie O'Hare said...

That's McHale & Ferraro. I mentioned that in the post, but maybe should have empasized it more.

Carol said...

Bernie, I just read your blog re: the Health Board, who from the Slate Belt spoke, I have been taken to 3 different ER's with my heart problems, depending on the severity and closeness of the ER at the time, never had a problem with any of them.Grateful for the care and compassion. Carol

Anonymous said...

The idea of a bi-county health department makes sense. Mostly because the folks in the townships are not covered. As they age and become infirm, we are headed for a crisis. Most people don't realize that it is the wealthy and middle class that are the most vulnerable in this situation.

Oh, and by the way, the state does a really good job of not inspecting restaurants in the townships. When you get food poisoning from one of your restaurants in the suburbs because they didn't have regular inspections, too bad.

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