Discussion of a county-level public health department briefly reignited during Wednesday morning’s weekly county commissioners’ meeting, held remotely for the first time.
Commissioner Ray D’Agostino proposed the idea of hiring a “specialized adviser” to assist the county for the remainder of the COVID-19 pandemic.
“The idea would be to bring on someone who has a specialization in health to be an independent adviser to the county,” D’Agostino said. “But I want to reiterate we are not looking at a public health department.”
Commissioner Craig Lehman, the sole Democratic member of the three-man board, saw it differently. He said that while he supported the temporary measure, the county needed to create “permanent public health capacity in county government.”
Lehman has supported a county health department for more than a decade. Commissioner Josh Parsons did not comment specifically on D’Agostino’s proposal.
While the topic has not been highlighted in county government in recent years, the conversation about creating a public health department in Lancaster County has been ongoing for decades.
In 1951, the Pennsylvania Legislature permitted counties and cities to establish public health departments, as noted by LNP|LancasterOnline’s Scribbler column Wednesday. Since 1951, 10 counties and municipalities have created their own departments. A 1967 vote to do so in Lancaster County narrowly failed to pass.
July 13, 1967: Local organizations begin working on petitions to get the question of a county health department onto the ballot
Nov. 8, 1967: County health department referendum fails in close vote
And beginning in 2004 The United Way of Lancaster County - along with the Lancaster Health Center and local physician-advocates like Dr. Albert Price - advocated for several years, ultimately unsuccessfully, for creation of a public health department.
“If you have your own health board, that’s a tremendous asset to have communications already in place,” Price, a retired pediatrician, said in an interview last month. “What I would hope might come out of this is rejuvenating the conversation.”
He believes the push for a county department was defeated because concerns over the cost and a fear in some that such a department may have been perceived as a way to control the agricultural industry and runoff into the Chesapeake Bay.
The push for a county health department gained a county government ally in 2008 when Randy Gockley, then the director of emergency management, said a public health department “would better prepare the county for health emergencies, such as pandemics.”
While he cannot say with certainty that a local health department today would lead to a better COVID-19 response, Gockley said in a call Wednesday that the state’s health department is often stretched thin and that a local board would enable more control.
“Without being (in county government) day-to-day I hate to make blanket statements, but my gut is telling me it made sense 10 years ago and it would make sense today,” he said, adding that the state may offer financial incentives to offset the cost.
Lancaster County’s current emergency management director, Phillip Colvin, said he would be able to work with either a state or county based department, but cannot speak to any potential advantages or disadvantages to a county system. He supports D’Agostino’s idea to create a public health adviser role.
Neighboring Chester County, with a population of roughly 522,046 to Lancaster’s 543,557, has a health department that costs approximately $11.4 million a year but offsets that with $9.2 million in revenue.
Delaware County, with an estimated population of 564,751, is planning to create its own department and has temporarily contracted with Chester County for services.
Both Delaware and Chester County generate about $50 million more in tax revenue than Lancaster.
Delaware County Council Member Elaine Paul Schaefer, part of a Democratic wave that swept to power in the county last November, said last month creating a health department is a top priority of the new board.
“This whole situation is a telling example of why one should be in place,” she said.
Schaefer did not give an estimate on what the board would cost, but said by not having one Delaware County is missing out on grant funding, and that a public health board “is completely worth the money.”