After jointly funding a feasibility study with State College Borough, Centre County will not be involved with the creation of a locally-governed health department, the county’s Board of Commissioners said on Tuesday.
Commissioners voted unanimously to notify the borough of the county’s intention not to establish an Act 315 health department.
Board Chair Michael Pipe said the county’s budget and the uncertain costs of creating and maintaining a health department were the primary reasons for opting out.
“As we’ve talked through some of our budget discussions, we have a lean budget, a focused budget and this is going to be a big lift that I think many of us believe this is not the appropriate time for the county to create a health office, if it ever would occur,” Pipe said.
“There’s a lot of unknown costs that other counties who have created health departments in the last several years, not only in Pennsylvania but in other states, have seen, so again because of that, and other reasons as well but that one being a chief one, I think we can agree this is not the best time to do this.”
Commissioners would offer whatever help and support they could if the borough chooses to proceed with the project, Pipe said. State College Borough Manager Tom Fountaine said the matter will be on Borough Council’s agenda some time in 2023.
The county and borough in 2021 split the $24,000 cost of a feasibility study to explore whether they might jointly or separately establish a state-authorized health department. Pennsylvania’s Act 315 allows counties and municipalities to establish their own health departments, giving local governments authority and some funding for community health efforts that would otherwise be under the control of the state health department.
Seven counties and four municipalities currently have Act 315 health departments.
Residents and some elected officials began discussing an Act 315 health department in State College or countywide in 2020 with the onset of the COVID-19 pandemic and whether such a department could better facilitate direct services and provide data to inform local decision making. The borough and county jointly formed a study committee in July 2021 and hired Gorenflo Consulting that November to conduct the study.
Gorenflo Consulting wrote in their report issued earlier this year that a locally governed health department offers timely and in-depth knowledge of health-related issues, the authority to protect and promote health in a way that best aligns with the local community, a tailored approach to existing and emerging health issues and threats, synergy among health organizations and the ability to attract more resources to the community.
The ultimate goal is to “optimize conditions in which everyone can achieve their full health potential,” according to the study.
Act 315 authorizes regular per capita funding, as well as grants, to counties and to municipalities which establish their own departments of health that meet state requirements. But the study noted that appropriations to local health departments have never reached their fully allowed amount, and while some grants are available on a competitive basis, there’s no guarantee they will be awarded.
The study did not provide a projected budget, but evaluated other local health departments in the commonwealth. The health department for the City of Wilkes-Barre, which with about 40,000 residents is comparable in population to State College Borough, had $1.2 million in expenditures and received $918,167 in state grants in 2021. The City of York, population 44,000, had $3.8 million in expenditures for its health department last year and received about $3 million in state and federal grants.
The dollar amounts were expectedly higher for county-level health departments. Erie County, which has about a 100,000 more residents than Centre but is the next closest in size among counties with a health department, spent $13.3 million in 2021 and received $9.6 million in grants for its department.
The bulk of health department budgets are spent on personnel. Act 315 requires the departments to have three executive level positions, access to a public health physician, environmental health inspector, public health nurse, disease investigation specialist, epidemiologist, health education provider and administrative support. Not all positions are full-time and can be contracted out.
“I think when you come down to the fact you have to hire doctors and other medical staff, and all the other administrative fees and costs and build up to it, I just don’t think it’s a win for us right now,” Commissioner Steve Dershem said.
Commissioner Mark Higgins said costs could potentially be much higher than initially thought and it appeared unlikely that state grants would cover enough of the budget.
“Also, I think there was some misperception on the board that there might be some possibility of providing direct medical care to citizens of Centre County, especially in our rural areas, and that also appears not to be covered by a health department of this type,” Higgins said. “So I think it drastically lowered our appetite for the project.”
