Cities show interest in establishing public health departments
A growing number of Inland Valley cities are watching efforts to the west to establish an independent public health department following months of frustration with Los Angeles County policymakers and their response to the coronavirus pandemic.
Leading that effort is the city of West Covina, now in the exploratory stage of what could be a lengthy process to break away from the Los Angeles County Department of Public Health. In recent months, the cities of Azusa, Claremont,
Diamond Bar, San Dimas and Walnut all have expressed an interest in the concept.
Across L.A. County, home to 88 cities, the pandemic has opened residents’ eyes to the power the public health department has over their lives. With a staff of more than 4,000 and an annual budget over $940 million, making it one of the largest such departments in the U.S., the public health department has legal jurisdiction over a region of 10 million people.
The department has forced cities to adapt quickly amid the pandemic with stay-at-home orders, off-and-on bans on outdoor dining, and other measures meant to slow the spread of the coronavirus. But officials in some cities say the county’s decisions have been arbitrary and not specific to their communities.
For months, West Covina Councilman Tony Wu has been vocal about wanting to work with county health officials to make decisions that benefit the community on a local level. While Wu says he’s not trying to pick a fight, he does want the city to look at other options, including breaking away from the county health department.
“This is going to destroy our businesses and our residents’ physical health. People can’t continue like this,” Wu said of the frequently changing county health orders. “For a city of over 100,000 population, we need a regional health department to track our own data and get the right response.”
Among the possible options the city is exploring is a smaller, multicity regional health department that would include cities in the San Gabriel and Inland valleys. At this time, cities such as Claremont and San Dimas have said they’ve done only preliminary inquiries into the matter but are interested in what path West Covina takes going forward.
One of the factors in pursuing a new health department is the ability to have a local health officer that would make decisions based on more localized data, said San Dimas Councilman Ryan Vienna. Those decisions, he said, don’t affect just the fiscal health of a community but the wellbeing of its residents.
“The measure of the total cost of the pandemic is not only in those tragically lost to the virus, but also those suffering with mental health issues or committing suicide which may be attributed to continued isolation,” Vienna said in an email. “Potentially having our own health officer and regional health department might just help us, as a city, save lives not only from the virus, but from the other factors that are very real to our citizens.”
The pandemic has been a “wake-up call” for cities looking for autonomy when making health and safety decisions for its residents, according to Dr. P. Basil Vassanta chart, a consultant and medical adviser working with the city of West Covina. He points to complaints about a lack of communication from the county as one of the major sources of confusion and skepticism among residents.
“People are hearing mixed messaging all the time and are left scrambling for direction,” Vassanta chart said. “The [San Gabriel Valley] is unique in its geographic area, and cities here want data advisory specific to their part of the region.”
At the opposite end of L.A. County, cities such as Lancaster, Santa Clarita and Palmdale are showing interest in the idea of a regional health department as well. Like West Covina, those cities are still exploring the idea with no firm plan yet in place.
Only a handful of cities in California maintain their own health departments, Pasadena and Long Beach among them. Another option for breaking away from the county is a joint powers authority, managed by a consortium of cities to provide health services, something that hasn’t been done in California.
Funding, staffing and self-sustainability should be at the forefront of discussions if a city is considering pursuing its own heath agency, said Kelly Colopy, director of Long Beach’s Health and Human Services Department. Accreditation and certification by state, local and national officials can be a lengthy process, she said.
“These cities would have to show that they are supported at a local level and are self-sufficient,” Colopy added. “If they can come to an agreement on the scope and scale and sheer amount of administrative pieces it would take, then there is a real possibility of making this happen.”
For funding, the majority of health departments are supported through federal and state grants, which can make them highly competitive, Colopy said.
Any decision to break away from the county, meanwhile, should be based on more than its response to the pandemic, Colopy said.
“I wouldn’t step in lightly,” Colopy said, adding that “there is frustration now because the pandemic is hard on so many people, but when it’s over there is going to be a lot to consider for the city if this is something worth pursuing. You can’t just back out.” Oscar Alleyne, chief of programs and services for the National Association of County and City Health Officials, said more cities have shown interest in starting their own health departments in the past year. That reaction, he said, is occurring in cities where officials and residents feel “sidelined” and want a personal and local approach to services in their communities.
“The role of public health has been waning over the last decade, and there has been massive underfunding throughout the country,” Alleyne said, “but I think people forget the invaluable work that they provide.”
While starting a whole new health department from scratch could prove difficult, joining forces with other cities may be easier, Alleyne said. The concept is already at work in such states as Tennessee and Louisiana.
“Health agencies are always getting creative and thinking of new solutions,” Alleyne said. “These are innovative practices that show how cities and regions are adapting like we are.”
In West Covina, the possibility of starting a regional health department is still months away. According to Vassanta chart, if the city decided to move ahead with the proposal, it would take until March 2022 before it could notify the county it was setting out on its own.
“If this can happen, it’s going to help the [San Gabriel Valley] and our surrounding cities for generations to come,” Wu said. “We just want our own say, that’s all.”