For years, it’s been a rub between the state Department of Health and Saratoga County that the county doesn’t have its own health department.
There are county public health nurses who visit shut-in patients and deal with communicable disease and even food poisoning outbreaks, but it’s not the same thing. They don’t inspect restaurant kitchens or test the drinking water at mobile home parks.
With 220,000 people, Saratoga County is the largest county in the state without a county health department. By law, it would have to establish one if the population hits 250,000, and the department must then be headed by a physician. Saratoga County is definitely heading in that direction; if it doesn’t hit that benchmark by 2030, I’ll gum my Red Sox cap.
The state clearly doesn’t want the county to wait for the 2030 census, and now the county has agreed to take over the public health responsibilities the state now fulfills — restaurant and food vendor inspections, sanitary code inspections, even tattoo and body-piercing parlor inspections.
Already, most New York state counties — including some with far fewer people, like Schenectady and Rensselaer counties — have full-spectrum health departments.
The state Health Department very much wants to dump those responsibilities — and the cost — onto Saratoga County government. There’s been pressure applied, as you might expect, and also a thin carrot offered: some $100,000 a year in state funding.
County officials — who with little prompting allude to the big financial challenges they face — aren’t thrilled about picking up major new governmental responsibilities. But we know who brings the bigger bat to this game, and the county doesn’t have much choice but to go along with what the state wants.
It turns out that more than a year ago, and rather quietly, county leaders agreed to move toward a full-service health department by 2016, as a condition for getting state approval of a new public health nursing director.
That wasn’t general knowledge until this week, when the county Public Health Committee named a new subcommittee to meet with the state Health Department and start working out the details.
“We’re going to be taking on a substantial burden, and my responsibility is to see we get it right,” said Ballston Supervisor Patti Southworth, who chairs the subcommittee.
A plan the county outlined to the state in March 2011 — which has already slipped a few months behind schedule — calls for the county to start out by hiring a consultant to plan the transition from a public health nursing service to a full-service health department.
In time, the county will need to hire an environmental health director and environmental health technicians, start conducting community health assessments,
and start planning for restaurant, public water supply, and all the other environmental inspections it will be required to do. At what point to hire a health commissioner — who must be a doctor — is up for debate.
They’re big responsibilities, ones that could easily cost the county more than $1 million a year. (Schenectady County, population 155,000, is spending $706,000 on environmental health programs this year, not including the commissioner’s salary, just for a comparison.)
“It’s a substantial cost to the county, that’s one of the concerns,” said Southworth, who as a pharmacist has some public health background. “In the times we’re in, the fiscal impact is tremendously important.”
People tend to take the safety of food and public water for granted, but when things go wrong — as with the E.coli bacteria outbreak at the Washington County Fair in 1999 — the consequences aren’t pleasant or pretty.
Don't park here
Here’s a move that became inevitable when the big Price Chopper parking lot in downtown Saratoga Springs was replaced earlier this year by a high-rise apartment building with a new Price Chopper on its ground floor.
The parking lot across the street at the county’s Woodlawn Avenue office building — the one where the public health nurses are located — is going to be posted as “parking for county business only.”
It’s parking for people coming to the nurses for immunization clinics and other services, as well as the nurses themselves. Since May, it’s become an attractive parking spot for people dashing to the new Price Chopper across the street.
Things will only worsen next year, when a movie theater complex is expected to open inside the old Price Chopper building, which is also right across the street from the nurses’ building.
Mind you, right on the other side of Woodlawn is the city’s new $4.7 million three-story parking deck — which is free, but a few extra steps away from the Price Chopper.