At State, Regional Health Bill Sparks Backlash
NEWINGTON - A proposed 1.5 percent contribution from municipal budgets to cover the costs of consolidating the state’s 72 local health departments and districts into 9 regional districts has been stripped from a bill currently before the House Committee on Public Health, but questions regarding how such an initiative would be funded remain, opponents of the proposal say.

       House Bill 7170 was introduced to a wave of opposition when it went to public hearing in late February, with only Commissioner Raul Pino-the author of the proposal-testifying in favor of it.

       Among those speaking out against the bill were various municipal leaders, health district officials, and CT Association of Directors of Health President Mike Pascucilla.

       In his letter to the Committee, Pino points to what he characterizes as a “fractured” public health infrastructure, throughout which the volume and quality of services from town to town and district to district can vary greatly.

       Consolidation, he said, is being pursued with the goal of providing health districts with increased access to grants and means to generate revenue, while leveling the playing field for residents of areas where services may be lacking.

       “The integration of local health departments and districts will ensure that all citizens in Connecticut have access to full-time, standardized local public health services,” Pino wrote. “Currently, over 172,000 citizens do not have access to full-time public health services. In Connecticut, there is significant variability in the types of services provided by LHDs as well as their capability to respond to public health emergencies.”

       But the bill’s opponents have pointed to a steady decline in the state’s public health investment-the statutory mandated minimum was reduced by 10 percent last year, with a proposed 10 percent reduction for this one-as well as a diversity of local needs.

       “While we support efforts to strengthen and improve our local governmental public health departments, we urge you to oppose a proposal that is significantly flawed, fails to include the municipalities in its conception and lacks a clear articulation of the need or value,” Pascucilla wrote in his letter to the Committee.

       Other testimonies placed particular value on a local-first model, expressing concerns that the disadvantaged residents Pino seeks to help with the proposal could be faced with additional challenges such as longer commutes to regional service centers.

       “In fact, many residents may not be able to access these services at all due to transportation barriers,” wrote Jenna Lupi, Co-Chair of the Connecticut Public Health Association’s Advocacy Committee. “Further, regional approaches may ignore the needs of small but vulnerable groups of individuals who lack a strong voice in a regional structure.”

       Under the legislation, each regional district would be headed by an appointed Executive Director, and governed by a 10 member Board to be composed by representatives from member towns.

       The structure, Pino said, is designed to retain a level of local control, but there’s still the question of how it will be funded.

       The bill states that districts serving at least 50,000 people-or containing a minimum of three member municipalities, regardless of population-would receive $1.85 per capita “town, city and borough of such district”. Budgets-drafted at the regional level-would have to be approved by the Commissioner.

       But critics want to know where the funding will come from, said Central Connecticut Health District Director Charles Brown.

       “They went from an incredible amount of money [the 1.5 percent] to us not knowing how much it is,” Brown said over the phone. “To go completely to the other side puts up red flags.”

       In his letter, Pascucilla raised other concerns-pertaining to the logistics of renegotiating a myriad of union contracts to align with the consolidation, property ownership by the current districts, and the preservation of services-provided in some districts-that go beyond the baseline CT DPH tenets.