Lehigh Valley Board of Health Presentation to the Health Commission October 17, 2011
Dec 18, 2015
Members of the Board of Health
David K. Bausch Robert B. Black, M.S. Eric J. Gertner, M.D., M.P.H. Carol A. Kuplen, R.N., M.S.N. David T. Lyon, M.D., M.P.H. Ilene S. Prokup, M.S., R.N., PHCNS, BC John F. Reinhart, M.Ed. Halyna I. Stegura, R.N., M.S.N. Vicky Kistler, M.Ed., Ex-Officio Judith K. Maloney, J.D., M.P.H., Ex-Officio
County Health Rankings
• Lehigh County — 37/67 Pennsylvania Counties
• Northampton County — 60/67 Pennsylvania Counties
Physical environment — Air quality
• Lehigh County — 54/67 Pennsylvania Counties
• Northampton County — 57/67 Pennsylvania Counties
Community Survey
• Muhlenberg College Institute of Public Opinion — Dr. Christopher Borick
• Spring 2011 Quality of Life Survey• Demographically representative of the residents of the Lehigh Valley
• 68% of respondents supported the establishment of a regional health department
48 community organizations have
committed their support to the establishment of
a regional health department …
AIDSNET American Red Cross of the Greater Lehigh ValleyArea Health Education Center (AHEC)Cancer Support Community of the Greater Lehigh Valley (formerly the Wellness Community)
Casa GuadalupeCenter for Humanistic ChangeChildren's Coalition of the Lehigh ValleyCJW and AssociatesCommunity Action Committee of the Lehigh Valley (CACLV)Community Services for ChildrenConnections for WomenDiscover Lehigh Valley
(formerly Lehigh Valley Convention and Visitors Bureau)
Dorothy Rider Pool Health Care TrustEaston Weed & Seed Health CommitteeFamily Connection of EastonGreater Lehigh Valley Chamber of CommerceLeague of Women Voters of Lehigh CountyLeague of Women Voters of Northampton CountyLehigh Carbon Community CollegeLehigh County Conference of ChurchesLehigh County Medical SocietyLehigh County Senior CenterLehigh Valley Academy of Family PhysiciansLehigh Valley Association of Independent Colleges
(Cedar Crest College, DeSales University, Lafayette College,
Lehigh University, Moravian College, Muhlenberg College)
Lehigh Valley Community FoundationLehigh Valley Economic Development CorporationLehigh Valley Nurse Practitioners' AssociationLehigh Valley PartnershipMethodist Services for Children & FamiliesNational Association of County and City Health Officials (NACCHO)Neighborhood Health Centers of the Lehigh ValleyNew Directions Treatment ServicesNorthampton Community CollegeNorthampton County Medical SocietyPartnership for a Tobacco-Free Northeast PennsylvaniaPennsylvania Association of School Nurses and Practitioners
Pennsylvania Public Health AssociationPlanned Parenthood of Northeast PennsylvaniaThe Public Health Faculty of East Stroudsburg UniversitySlate Belt Communities that CareSlate Belt Chamber of CommerceSlater Family NetworkTwo Rivers Health and Wellness FoundationUnited Way of the Greater Lehigh ValleyUniversity of Pittsburgh, Center for Rural Health PracticeUniversity of Pittsburgh School of Public HealthWeller Center
Chronic Disease Prevention Programs
Expected number of people served: 31,000
• Cancer prevention• Heart disease prevention• Osteoporosis prevention• Tobacco cessation and prevention• Nutrition education
Maternal and Child Health Promotion Programs
Expected number of people served: 7,100
• Child/adolescent advocacy, home visitation• Childhood lead poisoning and prevention• Dental health• Teen pregnancy prevention• Child death review• Healthy woman program
Communicable Disease Control
Expected number of people served: 59,100
• Communicable disease investigations5,100
• Community immunizations33,000
• TB/STD/HIV/AIDS21,000Total Personal Health
Services Staff60
Food Protection ProgramExpected inspections: 7,500
• Establishment inspection/licensing– Food service establishments
• Temporary• Mobile• Retail
– Vending machines
• Food-borne disease surveillance and investigation
• Food safety training and public awareness
Environmental ControlExpected inspections: 9,200
• Housing hygiene and sanitation• Lead source reduction• Vector control• Noise control• Indoor air quality• On-lot sewage disposal• Pollution incident response• Public health nuisances
Health Bureau Staffing Summary
Personal Health Services60
Environmental Health Services32
Health Bureau Physician Director,Management, Quality Assurance and Support 12
Total staff 104
Institutional SanitationExpected inspections: 1,500
• Child-care facility inspection• Public bathing place sanitation• School sanitation• Long-term care facility inspection
Total Environmental Health Services Staff
32
Lehigh Valley Health Department
Major Budget Assumptions• Bethlehem and Allentown opt-in to new bi-county health department
• Start date — July 1, 2012• Current Allentown and Bethlehem staffs will be retained in comparable positions and with comparable benefits
• The counties will approve the Health Department budget and service levels annually through the Health Commission
Major Budget Assumptions
• Salaries will be increased at 2% per annum for budget purposes
• Needs assessment will start immediately and regional “satellite” offices will be established
• The Health Department will continue to receive in-kind services from health care providers, in the form of lab tests, x-rays, materials, clinical personnel, etc.
Lehigh Valley Health Department
Expense budget for first full year — 2013
• Salaries and Benefits $7,469,549• Operations $2,131,615• Total Expense $9,601,164• 5% less than previous budget proposal• Incremental budget increase of $4,344,242
over combined Allentown and Bethlehem 2010 budgets
• 104 full-time employees (FTEs) — an increase of 40 FTEs over Allentown/Bethlehem 2010 levels
Lehigh Valley Health Department Funding sources
• PA Act 315 @ 4.11 per capita (of 6.00 p.c.available)
• PA Act 12 and Act 537 (Sewage Facilities Act)• Cities (ABE) contributions @ 3.75 per capita• Community contributions• In-kind services from local health providers• Categorical grants• Fees• County contributions — fixed at $450,000 each
through FY2016
Alberto Cardelle, MPH, Ph.D., East Stroudsburg
UniversityGrant from Two Rivers Health and Wellness
Foundation
53 Pa. Counties Without Health Departments have significantly lower
health rankings than 322 U.S.
“Peer” Counties With Health Departments
Counties with local health departments . . .
64th percentile in Pa. Health Outcome Rankings
Peer Counties without local health departments . . .
37th percentile in Pa. Health Outcome Rankings
New Study by Mays and Smith Shows Increased Public Health Spending
can Save Lives
• Infant deaths per 1,000 live births -6.85%
• Heart disease deaths per 100,000 population-3.22%
• Diabetes deaths per 100,000 population-1.44%
• Cancer deaths per 100,000 population-1.13%
Mortality ratesPercent change per
10% increase in spending
Asthma Impact is Significant
• Annual cost to U.S. — $20 billion• Average annual cost to asthma sufferers — $3,300 each
• Pa. asthma patients have over 10,000 hospitalizations per year
• 60% of children and 35% of adults with asthma miss school or work on the average of 12 days a year
• Conservative estimate: $27 million in annual loss of income to Lehigh Valley asthma sufferers
Public Health Education Interventions will Help
• Examples: medications, asthma triggers, self management/monitoring techniques
• Example of successful intervention: Gallefross, 2011– $122 cost per adult to administer– 71% reduction in loss of work days
• Targeted intervention administered to 5,000 LV adults:– Cost: $600 thousand– Savings: $3.7 million (in lost work days @ 25%
percentile income level)
– ROI: 478%
Cardiovascular Disease (CVD)
• Accounts for 1 of every 2.9 deaths in the U.S. — one death every 39 seconds
• Total costs in U.S. estimated at over $500 billion per year
• Heart disease leading cause of death in PA — over 26% and over 40,000 deaths a year
• In LV, over 120,000 adults suffer from hypertension and 60,000 from CVD — 15,000 are hospitalized per year
• LV sufferers miss over 400,000 workdays each year at a cost of over $15 million
Public Health Prevention Programs will Help
• Education-based programs to alter knowledge and attitudes
• Teach skills to make behavioral changes for a healthier lifestyle
• Conservative example: Farquhar Program – 1990– Cost to administer: about $20/adult– Result: 16% reduction in prevalence of CVD
and associated lost work days
• Prevention program administered to 10,000 LV adults– Cost: $200,000– Savings: $1.1 million (in reduced lost work days only)– ROI: 480%
Numerous Studies have Shown
That Every Dollar Spent on Prevention Yields As Much As $20 in Reduced Health
Care Costs
East Stroudsburg UniversityEconomic Impact Analysis
• Net Additional Spending $4,344,242• Net Additional Employees (FTEs) 40• Total Economic Impact $7,895,225• Total New Jobs Created 85
Using multipliers established by the U.S. Department of Commerce, Bureau of Economic
Analysis
A bi-county health department will . . .
• Create a healthier Lehigh Valley and improved quality of life
• Be the first ever in Pennsylvania
• Extend public health services to over 450,000 Lehigh Valley citizens (over 2/3 of the population)
• Provide over $9.6 million in services annually by leveraging $450,000 in County contributions, a small fraction of both county budgets
A bi-county health department will . . .
• Provide a strong return on invested public dollars through effective disease prevention/health promotion programs
• Insure that all local restaurants are inspected at least annually
• Provide a comprehensive, coordinated response to a communicable disease outbreak, natural disaster, or other public health emergency
• Inject nearly $8 million into the LV economy and create 85 new jobs