No matter how good something is, there’s almost always room for improvement.
That’s certainly true for health care. In communities across the country, including in Berks County, gaps exist. Health care systems are seldom able to provide everything to everyone.
But that doesn’t mean that shouldn’t be the ultimate goal.
That’s why people gathered Thursday morning at the Stonersville Social Club in Exeter Township, where the Berks County Medical Society hosted an event to review a study about how the county can help fill local health care gaps.
The study, which was authorized by the county commissioners, was unveiled in April. It was meant to help gather information regarding the health of county residents and create recommendations to enhance the delivery of health services.
The focus of Thursday’s forum was on practical ways for county leaders to take the next steps.
Medica society Executive Director T.J. Huckleberry said the study shined a light on how the community should be making more health decisions at a local level. It also showed that health services need to be more coordinated and that more people should have a voice in how those services are delivered.
That message was driven home through a series of four short videos presented during the forum. Each presented a different local official speaking about the health care challenges they see in the county.
Dr. Jill Hackman, executive director of the Berks County Intermediate Unit, spoke about the important role school officials play in monitoring the welfare of children in their classrooms. She said that includes their physical health and their mental and emotional well-being.
And schools need some guidance in doing that, she said, particularly given how many students they serve.
“When I think about Berks County being the ninth largest county in the commonwealth out of 67 counties, you can see the population needs direction — not only during an emergency but also with coordination of preventative services,” she said.
Anthony Tucci, CEO of Western Berks Ambulance Association, spoke about how a local health department would have helped guide first responders through the COVID-19 pandemic as they dealt with equipment shortages.
“Local health departments can meet the needs of the local community,” he said. “They are not looking at Pennsylvania as a whole. They are looking only at Berks County.”
Dr. Ankit Shah, who performs emergency medicine at Reading Hospital, said having a local voice that really understands what’s going on in the community would be a huge help for health care providers.
“One of the ways a local department of health can help is by innovating and helping to push programs that meet patients where they are,” he said.
Dr. Michael Baxter, past president of the Berks Medical Society, said a health department could level the disparities in the availability of medical and mental health services in the county.
“We are, as a county, worse off than some of the counties surrounding us,” he said. “It’s our responsibility now to put policies together like the recommendations in this study that will help us take the steps to build healthier, stronger communities for the future.”
In between the videos, a panel of local community leaders and health experts talked about the report in a discussion led by moderator Joe Watkins, a former aide to President George H.W. Bush and a national media personality.
Watkins said the purpose of the program was not to lobby for creating a health department. It was to offer community perspectives that will help the next board of commissioners decide what makes sense for the county.
“Today is just the beginning — not the end of the conversation,” he said.
Examining the recommendations
- Create a county health director position to lead public health collective action and coordination and serve as a trusted communicator about public health information.
Jeanne Franklin provided some thoughts on the importance of having a public health director from a personal standpoint.
She’s the health director for Chester County, and she said the very definition of public health can be confusing for some because it goes beyond just meeting a community’s medical needs.
“Public health is doing everything possible to ensure all residents have equal access to what they need to be the healthiest and most productive in their lives,” she said. “It includes looking at the health care system, health care policy and the environment.”
Chester has had a health department since 1968. Its roles include inspecting restaurants, campgrounds and swimming pools; providing immunizations; promoting healthy living; providing environmental health education; preventing chronic diseases and much more.
But, Franklin said, one of the most important roles of the department is to build partnerships and connections with other organizations working to improve the health of the community.
“Together we can build a better network of public health,” she said.
Franklin said county leaders help guide the mission of the department, which can vary greatly from county to county depending on community needs. She stressed that the actions and recommendations of these departments are based on scientific facts and often in tandem with elected leaders.
“I was making a lot of decisions during the pandemic, but I wasn’t making them alone,” she said. “I have a wonderful team behind me with real expertise that I was sharing with our county leadership, which includes emergency services who do this all the time. They helped balance our decisions.”
Franklin said having a team of dedicated people focused on improving public health is well worth the cost associated with the department’s tasks.
The department has an annual budget of nearly $26 million, generating that revenue from local, state and federal sources. The contribution from the county is about $5.3 million, which means each taxpayer is on the hook for about $10.
- Develop a Berks County Public Health Advisory Panel to advise the health director and guide public health assessment, policy and assurance activities.
Panelists Dr. Debra Powell, chief of the division of infectious disease at Reading Hospital, and Dr. Jamie Chmielowski, a pediatrician at Reading Pediatrics, discussed this idea.
Both know something about the concept, having each served on the Berks County COVID Health Advisory Panel in spring 2020. Powell and Chmielowski said they saw firsthand the benefits of having a group of physicians, community leaders and emergency service providers to help guide decisions.
“It showed us that we can all work together really well,” Powell said. “The nice thing about the panel that we had is we came from different backgrounds, but we all stuck to the facts. It was not a political committee, it was a group focused on the ways we could keep our community safe.”
Powell said the primary focus was on improving the health of community members. And making sure local voices were at the center of the conversation was the key to ensuring positive outcomes.
“We know this community, we know what the resources are for the most part and we know the people,” she said.
Chmielowski echoed that sentiment, saying local health providers have a special connection with the community.
“We know the community, but more importantly, they know us,” she said. “They trust us and they listen to us.”
- Support the establishment of a Healthy Berks Coalition to coordinate public health efforts in the county. The health director would coordinate the activities of the coalition.
Panelists Marcia Goodman-Hinnershitz, a Reading City councilwoman and director of planning and resource development for the Berks County Council on Chemical Abuse, and James Reece, executive director of Friend Inc. Community Services, took part in this discussion.
Reece said a coalition could help bring together a variety of people who are already working to tackle issues that are affecting people in all corners of the county: poverty, food insecurity, mental health issues, substance use disorders and domestic violence.
He said many people living in rural communities face similar challenges as those living in urban areas. But how you deliver those services and what the outreach looks like may vary. That, he said, is a good example of why diversity is needed in a coalition.
“It will take a community coming together with various perspectives,” he said. “And there is bound to be competing voices, but science needs to be the focus. I think we will all agree that we would be better off with a healthier community.”
Goodman-Hinnershitz said a coalition would help navigate the bureaucracy that often exists when it comes to advocating for policy change or competing for federal dollars.
“I think bureaucracy can be overcome as long as everyone is moving in the same direction,” she said. “We know what the issues are, we know what some of the solutions are, and it’s our job to be advocates to educate leaders at other levels of government.
“If we can get a common voice at the local level that makes us stronger at being able to impact state and federal policy that may support what we need to do.”
- Create a county health analyst position to improve public health data completeness and accuracy. This person would report to the health director.
Panelists Dr. Charles Barbera, president of Reading Hospital, and Carolyn Bazik, director of Co-County Wellness Services, discussed this idea.
Barbera said the goal of a public health department is not to treat diseases but to make sure we don’t get sick. And that means identifying where vulnerable populations are, what people are vulnerable to and making sure resources are being invested properly.
“We have to look at the statistics so that we know where the greatest needs are in the community,” he said. “And then we have to track the outcomes of that work to better understand if what we are doing is making an impact.”
Barbera said the health care community needs trusted data to decide how best to use limited resources.
Bazik said the county could have a public health director, an advisory panel and a community coalition, but without data to draw on they won’t be able to identify the pockets of need that are driving health care disparities.
“That data analyst position is extremely important,” she said. “We need to gather that information so that the people who have to make decisions know how to make the decisions to serve the public the best.”
The county’s plan
All three county commissioners attended Thursday’s forum. Whoever holds their positions after the November general election — where all three posts are on the ballot — will make most of the major decisions about the recommendations in the study.
Commissioners Chairman Christian Leinbach spoke briefly at the end of the event, thanking participants for sharing their insights.
Action on the recommendations won’t be coming soon. The commissioners passed a resolution this month stating that no formal action on the study will be taken for the remainder of the year. That move is in deference to whoever wins the election and serves on the board in January.
Source: Berkshire mont