The Quiet Dismantling of Public Health: The Impact of Pennsylvania State Health Center Privatization and Staff Cutbacks
Until 1996, public health staff at a statewide network of 60 Pennsylvania state health centers provided tests for HIV, sexually transmitted diseases (STD) and tuberculosis (TB); treated people with communicable diseases; conducted community outreach to inform, test, and treat others at risk; immunized infants; and investigated and responded to food-borne and other disease outbreaks. These staff, primarily public health nurses, also provided maternal and child health care, injury and lead-poisoning prevention services, and public health advice to child care centers, schools, and physicians. State spending on the state health centers, part of the annual appropriation of the Department of Health, was $15 million in 1996-97.1
In February 1996, Governor Ridge proposed the privatization of all Pennsylvania state health centers and the state public health laboratory. Without a feasibility study or cost-benefit analysis, the Governor’s office projected that privatization would yield a $1 million savings in the first year and $8 million annually thereafter. The Legislature responded by passing Act 87, which prevented the full-scale privatization of the state health centers and prohibited the Governor from privatizing the state laboratory.
Act 87 allowed the Department of Health to privatize, on a pilot basis, three state health centers for a period of one year. The Department privatized state health centers in Butler, Berks, and Dauphin counties and contracted four clinical services to private bidders:
- HIV counseling and testing;
- screening, testing, and treatment for sexually transmitted diseases; and
- screening, testing, and treatment for tuberculosis.
Act 87 also prohibited the Department of Health from reducing the “scope of services” at the remaining 57 health centers.