Nearly three months after Manheim Township commissioners asked other local leaders to join them in calling for creation of a county health department, boards in only a handful of the county’s 60 municipalities have done so.
About 20 boards have discussed the issue so far, according to LNP/LancasterOnline reports from municipal meetings around the county. Including Manheim Township, four boards representing 105,000 county residents — or 19% of the county’s population — have endorsed the move, while 11 boards representing 11% of the county’s population have voted against it.
Five other boards discussed it but took no action, and Ephrata Borough plans to vote on it next week.
But about 40 municipalities, representing a majority of the county’s population, have not publicly taken up the matter at all. Many are members of the Lancaster County Association of Township Supervisors, which advised its members against supporting the resolution, citing potential cost as one factor.
In a statement this week, Manheim Township said it invited partners to join its efforts because, “Our goal was to start the conversation on establishing a health department” and it hopes they “will continue to debate the issue of a Lancaster County Health Department to better protect the health and safety of Lancaster Countians in the future.”
But the next steps in that conversation are unclear.
Resolution passed in March
The Manheim Township commissioners passed their resolution in early March, calling on the county to create a health department and citing the COVID-19 pandemic response.
Among municipalities, support and opposition has fallen largely, but not entirely, along rural and urban as well as political lines.
Manheim Township and Lancaster city, the county’s two most populous communities and both led by Democrats, voted in favor of the resolution. They were joined by Denver and Marietta boroughs, two much smaller municipalities, one conservative and one politically competitive.
Otherwise, it has been mostly rural, conservative townships and boroughs that voted against the resolution or took no action on it.
Meanwhile, a Franklin & Marshall College poll of 2,000 Lancaster County adults last fall found strong public support for a county health department, though some public officials have criticized the poll’s methodology and results.
County leaders weigh in
While County Commissioner Craig Lehman, the sole Democrat, has supported creation of a county health department, his two Republican colleagues, Commissioner Josh Parsons and Commissioner Ray D’Agostino, have argued that the 1950s law establishing county health departments is antiquated and creates an unnecessary layer of bureaucracy.
Some of the communities that voted against the resolution took similar positions.
“I think this is a knee-jerk reaction to the COVID pandemic,” Mayor Leo Lutz, of politically competitive Columbia Borough, said in April. “I can’t support another layer of government.”
Others, like Mountville Borough Council member Richard Spiegel, were worried about the cost. Jerry Long, chairman of the Brecknock Township supervisors, worried that the cost would get pushed back onto the municipalities. He cited the county’s drug task force, which has been a contentious financial issue between the county and the municipalities.
Next steps unclear
The Manheim Township Commissioners, meanwhile, plan to discuss the issue and consider next steps on the resolution by the end of June, said Chairman Tom O’Brien.
O’Brien said his board is disappointed more municipalities haven’t joined in, but he’s hopeful because of the results of the F&M poll and the public support it identified for a county health department.
“We truly believe that it needs to be done and we’re going to find a way to event make it happen in some way, even a small way,” he said.
Lehman, the county commissioner, said he still supports a health department and believes the current law is a workable one, but added that he is open to change.
Parsons said that as a conservative he would need to see data that would justify the multi-million dollar endeavor. He also noted that the Lancaster County Association of Township Supervisors represents two-thirds of the county’s municipalities, adding weight to the number of municipalities who are opposed.
“Yes, the 1950s law is antiquated,” Parsons wrote in an email Friday. “We have already created an emergency health response capacity in County government this past year and I am open to other discussion if it is premised on doing it in a limited and fiscally responsible way.”
Commissioner Ray D’Agostino said he believes some level of health capacity is necessary, and pointed to the county’s new health and medical coordinator position as filling that need. But as it stands now the structure of a health department under the current law is “unwieldy,” he said.
“If the laws are updated, I would be in favor of reviewing the changes to see how the laws would impact Lancaster County and if it would be prudent and beneficial to develop some further health capacity within the County,” D’Agostino said in an email Friday.
“I have been in contact over the past several months with the County Commissioners Association of PA (CCAP) and county commissioners across the Commonwealth regarding these laws. The overwhelming consensus in these discussions is that counties that do not have a health department believe that these laws need to change before they would take a step toward creating a health department.”