Delaware County Council Vice Chair Monica Taylor

Delaware County Council Vice Chair Monica Taylor says the county will conduct a national search “to make sure we’re going far and wide and get the best health director that we can for our county health department.” — WHYY photo/Kimberly Paynter

Delaware County plans to open a wellness center next month in Yeadon that will serve as its base of operations for coronavirus testing and vaccine distribution — and eventually will become the bricks-and-sticks home of the county health department.

“The immediate use is going to be for COVID testing and vaccine distribution. But we hope in the not-so-distant future, when we open our health department in January 2022, that it will also be the hub for our health department, with possible satellite locations around the county,” said Dr. Monica Taylor, vice chair of the Delaware County Council.

In September, the County Council approved a five-year lease agreement with the Yeadon Shopping Center for the 1,235-square-foot space at 125 Chester Ave. The “workhorse site,” set to open on Jan. 15, will be staffed with agency nurses and administrative workers until the county can hire its own health workers, according to Rosemarie Halt, Delco’s COVID health policy consultant.

The site, for which the county will pay an annual rent of $185,400, used to be a supermarket and meets the county’s electrical needs. But the location also serves a larger purpose.

“We wanted to make sure that we were on the eastern side of the county, to target our largest population areas but also our areas that are of the most in need, and we also wanted to make sure that our location had several options for access to public transportation,” Taylor said.

Upper Darby and the city of Chester may eventually serve as satellite sites for the health department once it is established.

With more than 565,000 residents, Delaware County is not only the largest county in Pennsylvania without a health department but also the largest in the country, according to Halt. Since the start of the pandemic, Chester County has taken point on Delco’s COVID-19 response.

The wellness center’s planned opening follows the County Council’s recent health department timeline update to the state. The county must comply with Act 315, Pennsylvania’s local health administration law, which will allow Delco to receive state funding for its health department services.

Taylor said the state Department of Health was “enthusiastic” about the progress the county has made.

Getting to the goal

The council began the process by commissioning a Johns Hopkins University study to determine the need for a health department. In August, county health figures participated in a WHYY virtual town hall on the study’s results that was attended by more than 200 people, and soon afterward Delco hired staff to meet immediate health needs. Most recently, the county issued a request for proposals for a financial consultant to conduct an economic impact study.

With 2021 quickly approaching, the first step in accordance with Act 315 is the certificate of approval, in which the state allows the council to move forward with the health department’s creation.

“After that, the council will put in a resolution and we’ll start to form our board of health. And once we form our board of health, they will be able to start the appointments of … the health director and so on and so forth, and start doing the hiring and all of that to prepare the department to actually be functional by next January [2022],” Taylor said.

At the council’s Dec. 16 meeting, the Health Department Steering Committee provided a rough timeline of the year ahead. The board of health is likely to be approved by April, with a health director approved soon after.

“Once we form the board of health, we will be doing a national search to make sure we’re going far and wide and get the best health director that we can for our county health department,” Taylor said.

After the health director is chosen, a budget must be created and the county can begin making programs and hiring staff. The county expects the approval of its municipalities by June, with additional state rulings on the county’s plan to follow.

Generally speaking, the wellness center is coming along at the right time.

“Our target date is Jan. 15. We still feel we are on target to open in January. But as you know, there are lots of things that are happening, including the storm this week that impacted supplies coming in,” Halt said.

The state requires that Delco’s health department have a health director, a director of public health nursing, a director of environmental health, and a physician who can also hold the title of health director. The county said that it wants a “modern” health department. To achieve that goal, it is looking to the Foundational Public Health Services model and the Public Health 3.0 model.

“They are using two national models as the philosophical and operational underpinnings of the health department,” Grace Gorenflo, principal of Gorenflo Consulting Inc., a Delco health consultant, said in a board meeting.

What a health department does and should do

The Foundation Public Health Services model requires that the county address specific program areas, such as communicable disease control, chronic disease and injury prevention, environmental public health, maternal, child, and family health, and access to and linkage to clinical care.

“It’s important to mention that everything that is required by Act 315 is captured in this model,” Gorenflo said.

The Public Health 3.0 model, which was released a few years ago, uses a five-step process that encourages collaboration and data collection.

“The health department is being designed in a way that would meet the Public Health Accreditation Board’s standards and measures,” Gorenflo said.

In April, Jessica Kronstadt, vice president for program research and evaluation at the Public Health Accreditation Board, co-authored a blog post detailing the critical role of local health departments during the coronavirus pandemic.

“I do think that we will really need to invest as a nation in our public health infrastructure. It’s been something that we’ve really ignored and put on the back burner for a long time, and I think this crisis has really shown how important it is,” Kronstadt said in an interview this week.

Kronstadt oversees the administration of the national voluntary accreditation program for state, local, tribal and territorial health departments. She sees value in the program for new health departments.

“I think the accreditation standards really offer a way of taking that big-picture look of what are the ingredients that we need to be able to serve our community,” Kronstadt said.

Those include addressing the social determinants of health as well as confronting infectious diseases, the effects of climate change, and the impact of racism on the health of communities, Kronstadt said.

Erika Martin, an associate professor of health policy at SUNY Albany, co-authored the blog post with Kronstadt. Martin said the invisibility of local health departments often leads them to be vulnerable to obstacles.

“Because they are underappreciated, they have experienced chronic underfunding, and that has certainly been an issue that’s come to the forefront with the pandemic now that we’re seeing that a lot of the big gaps in our public health system have really been exposed,” Martin said.

The recent politicization of COVID-19 has made the problem worse, she said, and undermined the authority of science leadership at the local level. Siloed funding from the federal level will not help solve those issues, she added.

With those obstacles in mind, Martin described Delaware County’s push for a health department amid the crisis as “bold” yet “important.”

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