Commissioners Consider County Health Department
By Jeanne Ruczhak-Eckman
LANCASTER -- Imagine for a moment after a relaxing family vacation your child becomes violently ill. You take him to your doctor who tells you that your son contracted E. Coli, a serious and highly contagious illness. The Pennsylvania State Department of Health takes four days to return your call to even get the ball rolling. What happens next? What do you do? This happened to one woman who testified Monday at a hearing before the Lancaster County Commissioners in support of a county health department.  

Sharon Greelish Cody recounted how - in the time it took our State Department of Health to even respond - the New England county health department where she had vacationed had done a full investigation, confirmed where her son had contracted the E. coli, had taken care of the threat, and notified others who might have been exposed. Her son had contracted the illness from a goat at the resort's petting zoo.

Greelish Cody was just one of several people who spoke in favor of forming a county health department at the three-hour long meeting. No decisions were made. Chairman Dennis Stuckey was fast to point out that yesterday's hearing was an information gathering process.

Dr. Hilda Shirk, Project Manager for the Partnership for a County Public Health Department, began the testimony yesterday. The Partnership, said Dr. Shirk, proposes to create a local health department under the guidelines of Act 315. Act 315 is better known as the Local Health Administration Law, passed in 1951. It outlines the functions of a county health department, how it should be organized and mandates ongoing state funding.

"We are recommending that the best fit for Lancaster is a health department that focuses on prevention, coordination, investigation and improved public health and safety across Lancaster County," said Dr. Shirk. "We don't need another clinic that duplicates existing services."

The proposed county health department would require a small office space. It would employ a staff of 18-21 people, about half of whom already exists and would simply shift from the state to county level. She estimated only $100,000 to $190,000 is needed from the county. She estimated a county health department could be functional by January 2009.

Other counties - like Chester County - are considerably larger than the proposed department here. Dr. Shirk pointed out that in the example of Chester County, that department also administers WIC (Women, Infants, and Children) and includes a health clinic.

"What we're talking about here in Lancaster County is not health care. What we're talking about is public health," said Commissioner Craig Lehman in favor of a county health department.

One area of public health that may be rolled into the county department is restaurant inspectors and food inspectors. Albert E. Duncan, CEO of Thomas E. Strauss, Inc., which includes Miller's Smorgasbord, spoke to the need for "qualified" inspectors.

"There is no need to add regulations ... we need a system that follows through on the regulations in place," said Duncan.

Coming from the position of a hospitality business, Duncan pointed out what a tourism nightmare a health problem could potentially be.

Dale Herr, of High Companies, stressed how quickly a disease could be in Lancaster County and emphasized the need for local control and local action.

"A local health department will assure local response in the event of a health crisis," said High.

Local response. Dr. Jeffrey Martin, Associate Director of Family and Community Medicine at Lancaster General Hospital, offered some insight into current situations in Lancaster County. Lancaster County, he said, has one of the highest rates of elevated lead levels in children in the nation, not just the state. The national rate of lead poisoning in 2006 in 1.21%. The rate in Lancaster County that same year was 14%.

"This is not just a city issue," said Dr. Martin.

The percentages are similar for children in the city as well as outside the city. Children with elevated levels of lead have shown lower IQ scores, more likely to be involved with the Juvenile justice System and more likely to drop out of school.

The air quality in Lancaster County is one of the worse in the nation, worse than Detroit, testified Dr. Martin. This leads to increased cases of asthma and other respiratory illnesses. A county health department, according to Dr. Martin, could map the cases to pinpoint problem areas within the county and target interventions at the problem areas.

Water quality is another challenge facing Lancaster County. Because Lancaster County rests mostly on limestone, which is porous, pollutants can move through groundwater sources. A 2006 study by Penn State's Agriculture Extension, found approximately 40% of private wells throughout the Commonwealth showed one or more pollutant.

Commissioner Scott Martin asked about more testing for private wells. There was some discussion about testing and water quality. However, there was no mention of the excessive development and sprawl that has consumed Lancaster County in recent years.

Dr. Martin mentioned several other public health concerns in the county. He implored the Commissioners to consider a county health department to take a preventative stance versus waiting until the problems and concerns become unmanageable.

The Commissioners made no decision yesterday but rather gathered information. If they would like to consider a county health department, the commissioners would need to include it as a budget line in the 2009 budget. Inclusion in the budget would not necessarily mean formation. Contact the Commissioners at 717-299-8300 to voice your opinion.

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