OP-ED | ‘Health’ Of Small Towns Threatened By DPH Proposal
“We didn’t ask for it; there’s no need for it,” Goshen First Selectman Bob Valentine told the Northwest Hills Council of Governments in October. “It’s a solution looking for a problem.”
It’s the kind of complaint you hear often from officials in small towns when the state, in its infinite wisdom, ponders the imposition of yet another unfunded mandate. It’s a tired refrain but a tentative proposal to abolish the state’s 70 local health departments and merge them into as many as eight larger districts, has suburban and rural towns up in arms. And they should be.
First and foremost, town officials are objecting to the cost. It seems counterintuitive, right? One of the chief reasons we hear for increased regionalization is that it improves efficiencies and creates more favorable economies of scale, resulting in savings to both the state and the municipalities. Who could possibly be against that?
But if savings is the goal, I don’t see how that’s going to happen to towns in rural and suburban portions of the state. Most of them already belong to regional health districts whose members include multiple towns.
My town, Salisbury, belongs to the Torrington Area Health District, which enforces state regulations dealing with septic systems, wells, food inspections, and other environmental health mandates, to 137,000 people in 17 towns and one city spread out over 611 square miles. That’s a lot of territory.
But I don’t object to the proposal based on the fact that my town and others like it have already regionalized their municipal health services. After all, it’s possible that further consolidation will result in additional savings. But I remain unconvinced.
If the draft plan developed by the office of state Health Commissioner Raul Pino is enacted by the General Assembly and signed by Gov. Dannel P. Malloy, towns throughout the state will suffer from sticker shock that will make the hair of the their taxpayers stand on end.
The new system, which will likely be segmented into eight districts defined by the old county borders, will be financed by 1.5 percent of the member town’s operating budgets, including the education side. According to municipal officials, this is way more than the towns are currently paying. Indeed the increase is staggering.
Valentine’s small town of Goshen would see it its contribution skyrocket by almost 1,000 percent, from $16,000 to the Torrington Area Health District up to about $150,000 to the state, if the plan is enacted. The impact in other towns will be similar. For example, in the Pomperaug District of Public Health, Woodbury’s contribution would rise from $82,806 to $480,000; Southbury’s from $169,386 to $990,000, and Oxford’s from $110,100 to $690,000.
It may sound like chump change to the state’s big cities but we’re talking mostly about small towns here. Salisbury, for example, has a total town budget of only about $14 million. The town’s contribution to TAHD would rise sharply from just over $25,000 to about $210,000.
If towns are forced to pay nine times what they’re currently paying for health services, spending in other areas such as education, affordable housing, and infrastructure will be crowded out. Either that, or taxes would have to be raised on the order of half a mill.
“On its face, it looks like it would significantly increase costs to small towns and reduce the level of services provided,” Elizabeth Gara, executive director of the Connecticut Council of Small Towns, told the Waterbury Republican-American.
Since it’s now obvious that the consolidation of health services will do nothing to help small towns achieve efficiencies, the question arises as to why the state is floating the idea of doing it in the first place.
Well, Gara said the state Department of Public Health told her the consolidation plan is meant to “address health disparities in the cities.” Indeed, a DPH spokesperson confirmed to the paper that the department would “continue to address health disparities in Connecticut in an efficient and cost-effective manner.”
I wonder which cities the DPH is talking about. Torrington Mayor Elinor Carbone says her city’s obligation to fund the health district would rise from approximately $193,000 to about $1.8 million under the proposal.
In one alternate plan under consideration by the DPH, the districts would follow county boundaries, but the state’s five largest cities — Hartford, Bridgeport, Waterbury, New Haven and Stamford — would each maintain their own health departments. That sounds like the state’s ridiculous minority representation law from which most of Connecticut’s cities (and the General Assembly) are exempt, but to which the little people in the hinterlands must strictly adhere.
It would be one thing for the state to cut aid to towns during a fiscal crisis of the sort we’ve seen for the last several years. But to force them to buy into a service that’s more expensive and gives them less control makes no sense. Unless, that is, the plan is to funnel more money to the big cities that put the current governor into office while punishing the smaller municipalities that aren’t his biggest fans. But state officials wouldn’t dare do that, would they?
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