Lackawanna County preps new department to improve residents' health

Sep. 18—Lackawanna County's upcoming launch of a new Department of Health will mean paying 30 to 40 more employees, adding $4 million in new costs and assuming duties state inspectors handle now.

This will all be worth it, county officials say, because residents will end up healthier and safer as state and federal reimbursements cover most of the costs.

The new department will provide medical care to people who can't afford it and target changing harmful individual behavior — smoking, drinking alcohol and poor diet. The county has higher rates of smoking, drinking, obesity and diabetes than the state as a whole, according to state Department of Health statistics.

Lowering the rates will take "a long period of time," said William Browning, director of the county Department of Health and Human Services.

"We're hoping then to have people assess them, treat them, follow them, get them involved in wellness programs," Browning said. "One of the problems when you do any initiative in government, people want to say, 'OK, all right, where are the results?' But if you don't start somewhere, nothing's going to change."

The department building will be at 315-331 Franklin Ave. where Browning said he hopes to have a full-service clinic open at least five days a week for people who can't afford health care. The Wright Center will rent room to create better access for its existing patients, "not providing services for us," he said.

The Wright Center declined to make anyone available for an interview, but issued a statement from attorney Jennifer Walsh, a senior vice president and executive counsel. Walsh said the centers look forward to "supporting Lackawanna County's new and exciting public health department initiative" and will release "more information as it becomes available."

The department will also take over state inspections of restaurants and other food-serving venues, mobile home parks, summer camps, public swimming pools, and school food and water supplies, plumbing, sewage disposal and playgrounds. The inspectors are undergoing training, Browning said. He didn't envision a department handling these duties, but local health departments must by state law, he said.

All this has and will cost plenty.

The county paid $5 million in September 2022 to buy the three-story, former PenFed Credit Union building on Franklin Avenue. The state provided $4 million of that with the county using federal American Rescue Plan Act money to cover the rest, county Chief of Staff Brian Jeffers said.

At their Aug. 16 meeting, the county commissioners awarded a $1.584 million contract to Mar-Paul Co. Inc., of Jessup, to convert the building's basement and part of the first floor for the medical clinic. The basement will include exam rooms, a nurse's station, a vaccine supply room, a tuberculosis isolation room, medical offices and bathrooms. The city Single Tax Office will take up the rest of the first floor with a drive-thru window for paying property taxes.

The upper two stories will include offices for Browning and supervisors and administrators of the Department of Health; the Office of Youth and Family Services; the county drug and alcohol treatment program; the Area Agency on Aging; the Center for Health & Human Services Research & Action, the county's nonprofit research arm; and health inspectors.

A $1 million grant once meant for The Wright Center will pay part of the renovation cost with reallocated state money covering the rest, Browning has said.

The renovations won't be done until next summer. In the meantime, Browning hopes to find temporary clinic space before the end of the year so state reimbursement starts flowing, but state certification is necessary first. The state and federal governments are expected to pick up about 80% of operating costs, Browning said.

The 2023 county budget lists about $2.7 million in costs and revenues for the Health Department. Through the end of August, county records show, the department racked up only about $755,000 in expenses out of almost $1.59 million in available revenues, according to a county-provided document.

For 2024, an early projection shows almost $4.71 million in expenses and almost $4.07 million in revenues, a $642,000 deficit. County Chief Financial Officer David Bulzoni cautioned the projection has not undergone scrutiny that could alter it. Browning estimates the department will cost about $4 million a year. He estimates the annual county share between $700,000 and $900,000 because of state and federal reimbursements. The department has hired about 20 employees, including department Director Sabine Charles , a lead epidemiologist, a deputy epidemiologist, four disease investigators, nurses and inspectors, Browning said. The county is paying inspection staff as they undergo training, he said.

Besides the clinic, the department will track more than 70 diseases, including measles, cancer, hepatitis, rabies, AIDS, tuberculosis and hospital-acquired infections, which Browning said are a huge problem. Epidemiologists will track outbreaks and infected people's contact with others to prevent further spread. The department will encourage vaccination when necessary.

The department will focus heavily on disease prevention by promoting programs that reduce smoking, excessive alcohol drinking and obesity, and increase physical activity and eating healthy. Based on state Department of Health statistics, the county has higher rates of death than the state from heart and lung diseases, cancer, accidents, diabetes, Alzheimer's, kidney disease and blood poisoning.

The department plans health fairs and other screening events to identify health issues "before they show up at the emergency room," Browning said.

"Traditionally, especially in people in poverty, they use the emergency enrollment as their primary care," he said. "And obviously, if you go to the emergency room, there's no real continuity of care. It's crisis based, and then you move on until you're sick again, and you go back."

Where neighborhoods lack access to fruits, vegetables or other healthy food, the department can work to change that, he said.

"Do we try to entice a business to come up there? Do we find funding streams to establish or subsidize us some type of farmers market on a regular basis, those kinds of things," he said.One big early push will focus on lead testing because cities with older housing like Scranton have lots of lead-based paint or pipes, he said.

Delaware County Public Health Director Melissa Lyon, whose Health Department opened in March 2022, said departments' focuses vary — anti-smoking campaigns, encouraging senior citizens to stay active, breast-feeding support for mothers in the workplace, public-school vaccinations and others. Immediate availability can make a difference because a state response usually takes longer, Lyon said. Delaware has a 24-hour, 7-day a week complaint line.

"We respond within 24 hours. And we've done that 100% of the time," she said.

Lackawanna County Commissioner Chris Chermak favors creating the department because he remembers the height of the COVID-19 pandemic caught everyone flat-footed.

"We had no one to turn to," he said. The push to create a department started "so we can react faster to something that might happen," Chermak said. During the pandemic, the county organized vaccination clinics with existing staff, for example.

"We're going to have people on staff," he said.

The rest of the time, the county will aim resources at health problems specific to the county, he said. The clinic can reduce pressure on local emergency rooms.

"The ERs are overwhelmed with people that use it as their primary care," he said. "I'm hoping this never happens again. I wish we didn't have to have it. And I don't want to spend any extra money. But if we can save one life, well, then it's worth it."

Commissioner Jerry Notarianni said epidemic virus outbreaks have become more frequent in recent decades and the county has an especially vulnerable senior citizen population.

"This last one caught the entire country off guard, the entire world off guard," Notarianni said. "We got a little help from the state but not a lot ... (and) actually not much help from the hospital systems. There were a couple of pharmacies that stepped up and were beneficial in the vaccination process. But we were basically on our own."

He said progressive counties take steps to prevent trouble before it occurs and that's what Lackawanna is doing, he said. The $700,000 to $900,000 cost does not amount to a lot of money in a budget of $150 million, Notarianni said.

"I mean you have to be prepared," he said.

Contact the writer: bkrawczeniuk@timesshamrock.com; 570-348-9147; @BorysBlogTT on Twitter.