Blog Archives

LV and Beyond: Regionalizing Public Health in Other States

Just last month, the Robert Wood Johnson Foundation released this short report summarizing the overall challenges to improving public health capacity through cross-jurisdictional relationships, conditions for successful relationships, and moving forward with regionalization.

Information was gathered through in-person interviews and site visits with executive leadership and important staff at organizations such as CDC, NACCHO, PHAB, and HRSA.  Researchers interviewed various local public health leaders and policymakers either interested or currently involved in regionalization in Colorado, Wyoming, South Carolina, Connecticut, New Hampshire, Nebraska, and Illinois.

Although these efforts are specific to location, the report provides insightful generalizations about regionalizing public health. Here’s a short outline of its key points:

Key barriers to improving cross-jurisdictional relationships:

  • A gap exists between elected officials and public health leaders in understanding population health.
  • There are differences in understanding, appreciating, and operationalizing cross-jurisdictional relationships within the public health practice community.
  • No common language or frame of reference exists for discussing cross-jurisdictional sharing.
  • Cross-jurisdictional sharing and regionalization are occurring in a range of ways.
  • Regionalization does not necessarily result in improved public health capacity or performance, but cross-jurisdictional sharing often does.

Conditions for successful cross-jurisdictional relationships:

  • Clarity of purpose (Policy makers and public health leaders must be clear about their purpose)
  • Incentives, especially financial, are helpful
  • Willingness on both sides—public health leaders and elected policymakers
  • Attention to environment, culture, and history (interplay of history, culture, and relationships must be addressed)
  • Role in governance (all parties should feel that they have sufficient voice and control)

So, how should we move forward with collaboration?

  • Elected state and local policymakers need to be involved in national public health systems development work.
  • Understanding of the local environment is essential to successful public health endeavors.
  • Cross-jurisdictional relationships vary greatly in their details and address a wide variety of needs, but they do not have to develop further beyond their original purpose.

The conclusion?:

Public health leaders and policymakers found that cross-jurisdictional relationships improve local public health. Although accreditation was not a central focus of the report, the public health leaders acknowledged that cross-jurisdictional sharing will likely be necessary for health departments applying for national accreditation.


Visit RenewLV’s Regional Health Department page for information about local efforts in the Lehigh Valley.

Building One PA event: Regional Solutions Key to Urban Revitalization

The mood at last night’s Building One PA event in Allentown was hopeful. Community members gathered to watch “The New Metropolis” documentary, which, among other things, highlighted the crucial link between urban revitalization and comprehensive regional planning. The discussion that followed also focused on the need to plan better on a regional level.

The documentary recounted the history of urban sprawl, starting with government policies put into place after World War II. These policies encouraged new developments on cheap farmlands with the aid of state and federal subsidies. Now, many decades later, these original communities are struggling with keeping up with finances, as new developments keep popping up in the outlying areas. Urban planning leaders in the film called for a better, more coordinated approach to planning, with Myron Orefield stating that “regional land-use policies–tied to infrastructure planning– are the key to smart growth.”

The discussion that followed among the panelists and audience members brought out some good commentary about what needs to be done to encourage reinvestment in our older communities. Mayor Pawlowski of Allentown stressed that policy changes have to be implemented on the statewide level. Current policies tend to favor new developments over efforts to rebuild aging infrastructure in older communities, which places an unfair burden on these communities. The panel encouraged community members to organize in their respective municipalities and keep working with RenewLV to find effective solutions to these issues.

This discussion will continue at the greater Building One Pennsylvania summit, taking place in Lancaster on July 16th. We encourage any interested residents and workers of the Lehigh Valley to attend this event on the 16th. Click here to register. To keep up to date on matters related to regional collaboration and urban revitalization, make sure to sign up for RenewLV’s e-mail list on our Join Us page.

Regional Governance Bill Gaining Attention

The Patriot News reported yesterday on a bill introduced by State Rep. Thomas Caltagirone that proposes to merge many of Pennsylvania’s municipalities together — essentially moving the system of governance from the municipal level to the county level. While many are saying that the bill will not stand a chance in passing through the legislature (it barely had any co-sponsors when the story broke yesterday), some are calling it a much-overdue piece of legislation.

The bill is certainly in favor of regional collaboration. The counties would absorb all municipal governance — meaning there would only be a countywide-structure of governance. While the bill may not seem popular within Harrisburg, many commentators at the Patriot News lauded it as a good idea, stating that the current system is “making the residents of the Commonwealth go broke.” One commentator stated: “The model is right next door in Maryland. They have county centered government, and they seem to do very well in managing their affairs.”

The Express Times editorial staff came out in support of the bill in today’s paper, stating:

The first step is to admit local government has a problem in structure. Then begin tying like-minded communities together, to see how government can work without giving up local voices. It’s not as if we’re rebuilding a society, as in Iraq or Afghanistan, where sectarian violence is the norm. Our system already works, just in a grossly inefficient way.

Personally, I become overwhelmed just looking at a map of Pennsylvania’s municipalities. The map below is featured in the Brookings report Back to Prosperity, A Competitive Agenda for Renewing Pennsylvania (which, as some of you know, was the impetus for RenewLV).

Is this really efficient?

Of course, convincing municipalities to give up local control will be difficult. But this bill takes a step in the right direction by creating a dialogue about this important matter. And the legislation does not call for municipalities to give up their local culture and charm. It merely examines an antiquated system of governance and asks “Can’t we do better?”

If you’re interested in the topic of municipal governance and would like to stay up to date on this matter, please take a second to sign up for RenewLV’s E-mail list by visiting our Join Us page. And please post your thoughts on this matter below. I would love to hear what the community has to say about this legislation.

Reminder: RenewLV Regional Transportation Forum Today

This is a reminder that RenewLV’s Regional Transportation Forum is TODAY, Monday, April 19 at the Historic Hotel Bethlehem (437 Main Street, Bethlehem).

The program begins at 6:30 p.m. with an informal reception at 5:30 p.m.

This community forum is an opportunity to learn about the prospects for restoring passenger rail service in the Lehigh Valley, as well as to discuss how a balanced, multimodal transportation system can help promote economic development, the continued revitalization of the region’s core communities, and sustainable growth in the Lehigh Valley.

The keynote speaker for the forum is David Taylor, Senior Vice-President and National Director for Sustainable Transportation Solutions at HDR. The forum will include a Presentation of Findings from the New NJT/SYSTRA Regional Transportation Study (commissioned by the Lehigh Valley Economic Development Corporation and Lehigh and Northampton Counties), followed by a Panel Discussion and Q&A on how the Lehigh Valley Moves Forward on Transportation and Transit-Oriented Development. Moderated by RenewLV Co-Chair Deana Zosky, the panel will include:

  • David Taylor – Senior Vice-President, National Director for Sustainable Transportation Solutions, HDR
  • Bob McNamara – Senior Policy Representative for Smart Growth, National Association of REALTORS
  • Armand Greco – Executive Director, LANTA
  • Joe Gurinko – Chief Transportation Planner, Lehigh Valley Planning Commission
  • Adam Krom – Philadelphia-based Transportation Planner

This event is presented by the National Association of REALTORS and the Lehigh Valley Association of REALTORS (LVAR). Event sponsors also include the Lehigh Valley Economic Development Corporation and the Lehigh Valley Partnership.

The event is free and open to the public. RSVP is suggested, but not required.

If you have any questions or concerns, please contact Beata Bujalska at bbujalska@renewlv.org or 484.893.1062 (w) or 732.809.8817 (c).

We hope you’ll be able to join us for the informal reception at 5:30 p.m. in the balcony of the Grand Ballroom, followed by the full program in the Grand Ballroom at 6:30 p.m.

Call for Regional Coordination in Time Capsule Letter

Over the weekend, the residents of Emmaus experienced a wave of nostalgia when the Borough opened its 50-year time capsule. Buried on the Emmaus Triangle and opened at Community Park, the capsule included various treasures, such as copies of newspapers, government documents, and family photos. But one item was particularly interesting, especially because of its relevance to RenewLV’s mission of promoting smart growth principles in the Lehigh Valley.

A letter written by W.D. Reimert, Managing Editor of the Call-Chronicle Newspapers, covers some of the aspects of governance in his time that seem to directly contradict the presumed philosophy of efficiency touted in the 1950s. Forward-thinking Mr. Reimert wrote, “When it comes to community effort and government, we are still living in the dark ages. Every community is a law unto itself…This is inefficient, expensive, wasteful of time and energy.” The problems of inefficiency, according to Reimert, will be “eliminated by the coordination of essential services all along the line.”

Ahead of his time, Mr. Reimert recognized that poor planning and fragmented governance would lead to future ailments for Pennsylvania. These two issues are often cited as the main culprits behind disinvestment in the older communities and the continued loss of open space. Indeed, the Brookings Institution’s Back to Prosperity study cited these features as ones that contribute to the hollowing out effect that much of the state is experiencing currently. The older cities are being abandoned for life in the outer townships. And many of the valuable assets that are associated with Pennsylvania are being left behind. These trends have had a dismal effect on the state’s economy and have placed unnecessary burdens on the taxpayers.

But there is hope for reform, and the letter from Mr. Reimert speaks to the changes that will be necessary for ensuring a prosperous and thriving Lehigh Valley and Pennsylvania. Most of the recommendations center on coordination of essential services – especially the water and sewerage utilities. Additional services that can be coordinated are “health services, street repair crews, planning bodies.”

Sadly, Mr. Reimert’s hopes that these changes would be fully implemented by 2009 have not been fulfilled. One salient example of this inefficiency is the 40 different publicly owned water and wastewater systems in the Lehigh Valley. A recent study showed that consolidation of these systems could save the region close to $56 million each year by the year 2020. And coordination would promote efficient use of the resources by encouraging development in areas with existing infrastructure. Yet we have yet to reach regional collaboration on this matter in the Valley.

Nonetheless, the hope remains that the vision of comprehensive coordinated planning in the Lehigh Valley will become a reality. Steps are being taken in the right direction. The Lehigh Valley Planning Commission has been essential in putting forward suggestions for the region that promote better planning of the land and the services. And RenewLV is working on various initiatives to ensure that regional collaboration will be achieved in the Valley. Renew’s mission to strengthen the core communities, preserve open space, and create a sustainable and equitable foundation for future growth encompasses the belief that coordination of the essential services will bring about a thriving Lehigh Valley.

But the residents of the Lehigh Valley need to contribute to this process. W.D. Reimert believed that these changes could not be achieved without “a great many persons … willing to provide leadership and imagination.” For this reason, I encourage you to become a supporter of RenewLV by visiting our Join Us page and submitting your information. You will become a part of the network of dedicated citizens working hard to ensure that this region will continue to grow in a coordinated and well-planned manner.

Examining Water Infrastructure

Several factors guide development and urban growth, and water infrastructure is a crucial one. The US Environmental Protection Agency has examined the effect of water policies on the way communities are shaped, concluding that the relationship between water infrastructure and urban growth is dynamic. That is, as much as growth affects the policies about water, so do water policies influence growth. RenewLV recognizes this important relationship and the Regional Water Initiative is an effort to achieve smarter growth in the Lehigh Valley through coordinated planning of the region’s water utilities. If you have not visited Renew’s Water Initiative page, I encourage you to do so now. On that page, you will find resources and suggestions for how you can help influence more sustainable water infrastructure development here in the Valley.

One useful resource on the EPA website is the manual Growing Toward More Efficient Water Use: Linking Development, Infrastructure, and Drinking Water Policies. The policy guide offers several suggestions for each level of government on how to better deal with the water infrastructure concerns, and, equally important, offers advice for how to better assess the development issues within individual communities. At times, water infrastructure is left out of discussions about land-use planning, because the issues are covered by two different levels of government. This disconnect can result in higher user fees and uncoordinated development. To ameliorate this problem, regional approaches, with a focus on improving existing infrastructure in the core communities, can lead to more efficient governance and better planning.

Again, I would suggest visiting the RenewLV Water Initiative page to look over the resources. Also, view the preview for Liquid Assets, a documentary about essential – yet often overlooked – infrastructure. The preview is on the Renew website, and here:

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