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Lehigh Valley Board of Health Presentation to the Health Commission

Lehigh Valley Board of Health Presentation to the Health Commission. October 17, 2011. 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

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Lehigh Valley Board of Health Presentation to the Health Commission

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  1. Lehigh Valley Board of HealthPresentation to theHealth Commission October 17, 2011

  2. 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

  3. Public health problems … EVERYDAY Vicky Kistler, M.Ed., Director, Allentown Health Bureau

  4. The Lehigh Valley is NOT healthy.

  5. County Health Rankings • Lehigh County — 37/67 Pennsylvania Counties • Northampton County — 60/67 Pennsylvania Counties

  6. Low birth-weight babies • Northampton County — 62/67 Pennsylvania Counties

  7. Obesity • Lehigh County — 26% of adults • Northampton County — 30% of adults

  8. Physical environment — Air quality • Lehigh County — 54/67 Pennsylvania Counties • Northampton County — 57/67 Pennsylvania Counties

  9. The Lehigh Valley is NOT healthy … And we deserve better.

  10. More than 2/3 of the Lehigh Valley’s citizens have inadequate access to public health services

  11. The public wants regional public health

  12. 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

  13. 48 community organizations have committed their support to the establishment of a regional health department …

  14. AIDSNET American Red Cross of the Greater Lehigh Valley Area Health Education Center (AHEC) Cancer Support Community of the Greater Lehigh Valley (formerly the Wellness Community) Casa Guadalupe Center for Humanistic Change Children's Coalition of the Lehigh Valley CJW and Associates Community Action Committee of the Lehigh Valley (CACLV) Community Services for Children Connections for Women Discover Lehigh Valley (formerly Lehigh Valley Convention and Visitors Bureau)

  15. Dorothy Rider Pool Health Care Trust Easton Weed & Seed Health Committee Family Connection of Easton Greater Lehigh Valley Chamber of Commerce League of Women Voters of Lehigh County League of Women Voters of Northampton County Lehigh Carbon Community College Lehigh County Conference of Churches Lehigh County Medical Society Lehigh County Senior Center Lehigh Valley Academy of Family Physicians Lehigh Valley Association of Independent Colleges (Cedar Crest College, DeSales University, Lafayette College, Lehigh University, Moravian College, Muhlenberg College)

  16. Lehigh Valley Community Foundation Lehigh Valley Economic Development Corporation Lehigh Valley Nurse Practitioners' Association Lehigh Valley Partnership Methodist Services for Children & Families National Association of County and City Health Officials (NACCHO) Neighborhood Health Centers of the Lehigh Valley New Directions Treatment Services Northampton Community College Northampton County Medical Society Partnership for a Tobacco-Free Northeast Pennsylvania Pennsylvania Association of School Nurses and Practitioners

  17. Pennsylvania Public Health Association Planned Parenthood of Northeast Pennsylvania The Public Health Faculty of East Stroudsburg University Slate Belt Communities that Care Slate Belt Chamber of Commerce Slater Family Network Two Rivers Health and Wellness Foundation United Way of the Greater Lehigh Valley University of Pittsburgh, Center for Rural Health Practice University of Pittsburgh School of Public Health Weller Center

  18. What will the Lehigh Valley Department of Health look like?

  19. Lehigh Valley Health Department Clinical Sites Bangor Easton Slatington Bethlehem Allentown

  20. Personal Health Services July 2012–July 2013

  21. Chronic Disease Prevention ProgramsExpected number of people served: 31,000 • Cancer prevention • Heart disease prevention • Osteoporosis prevention • Tobacco cessation and prevention • Nutrition education

  22. Maternal and Child Health Promotion ProgramsExpected 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

  23. Communicable Disease ControlExpected number of people served: 59,100 • Communicable disease investigations 5,100 • Community immunizations 33,000 • TB/STD/HIV/AIDS 21,000 Total Personal Health Services Staff 60

  24. Environmental Health Services July 2012–July 2013

  25. 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

  26. 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

  27. Health Bureau Staffing Summary Personal Health Services 60 Environmental Health Services 32 Health Bureau Physician Director, Management, Quality Assurance and Support 12 Total staff 104

  28. 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

  29. Financial Plan

  30. Lehigh Valley Health DepartmentMajor 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

  31. 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.

  32. Lehigh Valley Health DepartmentExpense 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

  33. 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

  34. Lehigh Valley Health Department Comparisons with 3rd-Class Pennsylvania Counties

  35. Alberto Cardelle, MPH, Ph.D., East Stroudsburg UniversityGrant from Two Rivers Health and Wellness Foundation

  36. Are communities served by public health departments healthier than those which are not? YES

  37. 53 Pa. Counties WithoutHealth Departments have significantly lower health rankings than 322 U.S. “Peer” Counties WithHealth Departments

  38. 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

  39. 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% Percent change per 10% increase in spending Mortality rates

  40. 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

  41. 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%

  42. 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

  43. 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%

  44. Numerous Studies have Shown That Every Dollar Spent on Prevention Yields As Much As $20 in Reduced Health Care Costs

  45. East Stroudsburg UniversityEconomic Impact Analysis Using multipliers established by the U.S. Department of Commerce, Bureau of Economic Analysis • Net Additional Spending $4,344,242 • Net Additional Employees (FTEs) 40 • Total Economic Impact $7,895,225 • Total New Jobs Created 85

  46. 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

  47. 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

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