State health centers again on budget chopping block

Feb. 20--A quiet set of offices in a corner of the Monessen Municipal Complex, decorated with bright posters touting vaccinations for diseases such as whooping cough, the flu and Hepatitis.

An office behind the County Assistance Office in Washington County, full of fliers and brochures advertising programs like Head Start and food bank sites that distribute free produce.

These state health centers are part of a network of 55 such offices around the commonwealth, many providing rural counties with public health services such as vaccinations, counseling and testing for sexually transmitted diseases and investigations of outbreaks of certain illnesses.

Under a budget proposal by Gov. Tom Wolf, these health centers could close, though administration officials say the public health services provided here would still be available elsewhere.

Following the Democratic governor's budget address earlier this month, Mr. Wolf's secretary of Policy and Planning, Sarah Galbally, said of the plan to close the centers: "It's really about moving people out into the community, not taking away services."

The community health nurses could work in other settings, according to budget materials from Mr. Wolf's administration, such as a local health department or County Assistance Office. Budget documents also state that the expansion of Medicaid has pushed the rate of people without health insurance in Pennsylvania to a new low, so some services once provided by the centers are now provided by primary care doctors.

Other centers in southwestern Pennsylvania are located in Armstrong, Beaver, Butler, Cambria, Fayette, Greene, Indiana, Somerset and Westmoreland counties. Brief visits by a Pittsburgh Post-Gazette reporter to two local centers on a weekday morning last week found empty waiting rooms in both.

The administration under then-Gov. Tom Corbett, a Republican, tried to close about half of the centers in 2013. But that effort was halted by a lawsuit brought by the Service Employees International Union Healthcare Pennsylvania, which represents the nurses at the centers, as well as several Democratic state lawmakers who represented areas where a center was slated to be closed.

The closures would "threaten an already fragile public health system in Pennsylvania," a union official said in 2013 of the Corbett administration's actions.

The Corbett administration also similarly stated that it made more sense to have nurses in community settings, rather than making people come to the health centers for services. Mr. Corbett's plan to consolidate 60 health centers into 34 would have eliminated 73 Department of Health positions, among them 26 community health nurses. His 2013-14 budget estimated a savings of $3.4 million from the consolidation.

Mr. Wolf's plan does not specify how many of the centers would close but says it will save $15 million.

Budget Secretary Randy Albright said those savings would come from reducing the physical footprint of the centers and also from "some of those employees now ... maybe find a different place in the unified agency" of Health and Human Services.

Mr. Wolf's $32.3 billion spending plan also calls for a number of cuts and consolidations, including combining four Cabinet agencies into one Department of Health and Human Services.

In a briefing following Mr. Wolf's budget address earlier this month, Health Secretary Karen Murphy declined to say how many centers would close. She said her agency would work with all involved parties to come up with the best plan.

Mr. Corbett did not seek approval from the state Legislature prior to starting to shutter centers, which was a critical point of contention in the lawsuit brought against his administration. The union and legislators' lawsuit pointed to a 1996 law that requires a minimum number of health centers in the state and says legislative approval is needed before any centers can be closed. The state Supreme Court agreed with this argument in a 2014 ruling.

It seems unlikely that the union, which has been allied with Mr. Wolf politically and generally supportive of his budget proposals, would sue over the issue again.

In a statement, Kevin Hefty, SEIU Healthcare Pennsylvania's vice president, noted that Mr. Wolf's proposal is part of a larger consolidation plan to create a Department of Health and Human Services and "find cost savings to address our state's $3 billion budget deficit without sacrificing quality or cutting front-line nursing jobs."

Mr. Hefty's statement also noted that Mr. Wolf and Ms. Murphy "have invited input from community health nurses to improve access to quality care and protect jobs as they develop this proposal. We are confident -- based on Governor Wolf's longstanding commitment to expanding and protecting health care access for all of our state's citizens -- that the new Department of Health and Human Services will continue to put the safety and well-being of [Pennsylvania] communities at the forefront of its decision-making."

Sen. Lisa Baker, R-Luzerne, who chairs the Health and Human Services committee, said she believes legislators are open to the idea of government consolidation but would have questions about community impact and how this would effect people who would be served by the centers.

Ms. Baker also noted that no local city or county health departments exist in many rural parts of the state.

"I think a hearing would be very valuable in assessing the details of a plan," she said.

"I'm very interested in getting into the weeds on the entire Health and Human Services portion of the budget. That's where the dollars are," said Sen. Judy Schwank, D-Berks, the ranking Democrat on the committee.

Kate Giammarise: kgiammarise@post-gazette.com or 412-263-3909 or on Twitter @KateGiammarise.

___

(c)2017 the Pittsburgh Post-Gazette

Visit the Pittsburgh Post-Gazette at www.post-gazette.com

Distributed by Tribune Content Agency, LLC.