Members of Delaware County Council plan to meet with state officials in Harrisburg next week to discuss the process of establishing a health department.
"We're hitting the ground running," Councilwoman Elaine Paul Schaefer said. "Next week, we have a meeting with the Pennsylvania Department of Health to start the process. This is a priority. This is definitely a priority for all five of us."
Council Vice Chairman Monica Taylor said as the process evolves, the public will be involved in open forums.
County Councilwoman Christine Reuther explained the difference between a health department, which does not exist in Delaware County, and the county Intercommunity Health Department.
One of the major components of a health department is its capacity to father information, such as causes of death, health barometers, diagnoses and location.
"Right now ... because we don't have a county department, we default to the state," she said. "We are the most densely populated county in the state without a health department. That is staggering to me. Given (our) population density, staying on top of public health patterns and trends is really critical."
As Delaware County's health statistics are transferred to the state, they compete with all of the other counties in the commonwealth that don't have county health departments, and no infrastructure, for the state's focus.
On the other hand, the Intercommunity Health Department, which Reuther noted does a good job of what it's purposed to do, monitors access to health care.
In addition, she said, "Under state law, unless a county has a public health department, the county has no ability to mandate the collection of information ... or enforce public health measures."
So, should an issue arise, such as a measles outbreak, county officials would not have the authority to implement a response plan - that would have to come from the state.
On Sunday, the Delco Transition Public Health Working Group held a panel discussion at Elwyn to listen to regional public health leaders explain what is involved in setting up and maintaining a public health department. Panelists included Chester County Health Director Jeanne Casner; Montgomery County Health Administrator Brenda Weis; former Philadelphia Health Department Commissioner Walter Tsou; Rosemarie Halt, state and senior policy director of the Maternity Care Coalition; and Delaware County Medical Examiner Frederic Hellman.
"To me, it couldn't have been clearer the benefits that that would bring in the long term," Schaefer said.
Schaefer explained that county council must also evaluate the costs of a health department, noting that the former council passed a budget with a $23 million deficit by drawing down reserves that could have been used for the formation of a health department.
"It's left us in a very challenging position to move forward with initiatives," she said.
Like Taylor, Reuther said farther discussions will take place, including conversations with stakeholders with foundation resources that could assist with implementing a new health department.
The first step in that direction is doing a health department assessment study, which could take approximately six months to complete. The county is undergoing a study to look at health delivery and access to care in the county by the Johns Hopkins University's Bloomberg School of Public Health.
A basic health department would include an epidemiologist and experts to collect the data and build the databases that are needed, Reuther explained.
"I don't know that we will ever have a health department the size of Montgomery County," she said, adding that once it's established, preliminary estimates place the cost of a county health department at about $2 per person, or more than $1 million, per year. That would be leveraged by the county receiving $2 to 3 million in additional funding from state and federal resources.
A county health department may be able to identify larger than usual clusters throughout the county with various health indicators or situations, allowing other officials to do their analyses to see if responses are needed.
For example, the U.S. Environmental Protection Agency continues its investigation of the Norwood Landfill, which preliminary soil tests were not found to pose a risk although community members provide numerous anecdotal instances of autoimmune disorders, Multiple Sclerosis and other types of cancer. The landfill itself consists of two sites: A 10-acre portion operated from 1950 to 1960 and another 15-acre site was used for one year from 1960-1961. Both sites operated prior to strict record-keeping or regulations.
Although the site does not meet the criteria at this point for inclusion on the National Priorities List as a Superfund site, EPA officials said they plan to expand their investigation, which could take years to complete.
"I think having a public health department will help us gather statistics and understand problems as they arise so we can do something about them," Schaefer said. "When you have a public health department, you are in a much better position to gather data and have it analyzed and be better informed in making delivery decisions."
Reuther did not want to presuppose a scenario as the EPA continues its investigation.
"I'm going to let their experts do their work," she said. "But I do think that when there is a place that people can report a problem that they think is paying attention to them, they are going to report the problem."
Reuther added that in Norwood, or anywhere else in Delaware County, should incidences begin to accumulate, a county health department would recognize that.
"Because we don't have a health department, we have no one tracking those problems," Taylor said.