Microsoft Word - Volume 14.doc i COMMONWEALTH: A Journal of Political Science EDITOR IN CHIEF: Gerard J. Fitzpatrick, Ursinus College ASSOCIATE EDITORS: Thomas J. Baldino, Wilkes University Donald G. Tannenbaum, Gettysburg College Michael R. King, Legislative Office for Research Liaison, Pennsylvania House of Representatives BOOK REVIEW EDITOR: Thomas J. Baldino, Wilkes University MANAGING EDITOR: Michael E. Cassidy, Office of the Democratic Caucus Chairman, Pennsylvania House of Representatives EDITORIAL REVIEW BOARD Aryeh Botwinick Temple University M. Margaret Conway University of Florida Roger H. Davidson University of Maryland Jean B. Elshtain University of Chicago Richard F. Fenno University of Rochester Marianne Githens Goucher College Susan W. Hammond American University Samuel Krislov University of Minnesota G. Calvin Mackenzie Colby College Michael J. Malbin State University of NY, Albany Harvey C. Mansfield, Jr. Harvard University Kenneth F. Mott Gettysburg College Craig N. Murphy Wellesley College Steven A. Peterson The Pennsylvania State University Mark P. Petracca University of California, Irvine H. Mark Roelofs New York University Bruce M. Russett Yale University J. David Singer University of Michigan ii Contents Volume 14..........................................................................December 2008 About the Authors ......................................................................................... iv Preface by Michael R. King ......................................................................... vii Introduction The Public Health System of the Pennsylvania Commonwealth: Where Do We Go from Here? ........................................................................... 1 Margaret A. Potter, JD, MS, University of Pittsburgh Graduate School of Public Health Part I. Critical Issues in Pennsylvania’s Public Health System Public Health Shortage Areas in Pennsylvania: A Barrier to Health Information .................................................................................................................... 7 Alberto J.F. Cardelle, PhD, MPH, East Stroudsburg University Deidre Holland, MPH, University of Medicine and Dentistry of New Jersey School of Public Health Crisis in the Making: What’s Wrong with Pennsylvania Public Health Law .................................................................................................................... 23 John A. Bozza, JD, MA, Judge of the Court of Common Pleas, Sixth Judicial District, Commonwealth of Pennsylvania Evidence That Young Children Are Falling Through the Safety Net: Policy Implications of Hunger and Poor Health in Pennsylvania ............................ 55 Mariana Chilton, PhD, MPH, Drexel University School of Public Health Michelle Renee Chyatte, MPH, Drexel University School of Public Health Edward Gracely, PhD, Drexel University College of Medicine Part II. Barriers to Building Local Public Health Capacity in Pennsylvania Counties Objecting to Public Health – Stories from Four Pennsylvania Counties ...... 83 Dennis Gallagher, MA, MPA, Drexel University School of Public Health Jennifer Kolker, MPH, Drexel University School of Public Health Financial Analysis and Structural Considerations to the Problem of Rural Public Health in Pennsylvania ........................................................................ 99 Alberto J.F. Cardelle, PhD, MPH, East Stroudsburg University iii Part III. Innovations for Health Protection A Health Promoting Hospital: A Strategy in the Re-Design of the U.S. Health Care System .................................................................................................125 Matthew G. Masiello, MD, MPH, FAAP, Windber Medical Center and Windber Research Institute, and Health Promoting Hospital Consultants, LLC Credentialing of the Public Health Work Force ............................................ 137 Bernard D. Goldstein, MD, University of Pittsburgh Graduate School of Public Health and National Board of Public Health Examiners Pennsylvania Medical Assistance: Connections within the Commonwealth’s Public Health System ........................................................ 163 Judith R. Lave, PhD, University of Pittsburgh Graduate School of Public Health Margaret A. Potter, JD, MS, University of Pittsburgh Graduate School of Public Health iv About the Authors John A. Bozza, JD, MA, is Judge of the Court of Common Pleas, Sixth Judicial District, Commonwealth of Pennsylvania, and formerly President Judge. He is also a faculty member at the National Judicial College, University of Nevada at Reno and the New Judges School of the Pennsylvania Supreme Court. Recently he was a member of the editorial board of the Pennsylvania Public Health Law Bench Book. Prior to taking the bench Judge Bozza served as an Associate Professor of Criminal Justice at Gannon University. Alberto J.F. Cardelle, PhD, MPH, is an Associate Professor of Health and currently serves as chair of the Health Studies Department and faculty assistant to the Provost and President of East Stroudsburg University. He has served as interim Vice-Provost and Dean of the Graduate School. Dr. Cardelle earned his Bachelor of Science degree in Biology and Latin American Studies at Tulane University, his master degree in Public Health from Boston University, and his Doctorate in International Studies with a concentration in comparative health policy from the University of Miami. Mariana Chilton, PhD, MPH, is an Assistant Professor at the Drexel University School of Public Health and the Principal Investigator for The Philadelphia GROW Project – a nutrition and growth initiative for children and their families (www.growproject.org). She is Co-Principal Investigator of the Children’s Sentinel Nutrition Assessment Program (www.C- SNAP.org). Dr. Chilton investigates the health impacts of hunger and food insecurity among young children aged zero to three. Michelle Renee Chyatte, MPH, is a doctoral candidate at the Drexel University School of Public Health. She has her BS in journalism from Kent State University and MPH from the Consortium of Eastern Ohio Master of Public Health. Prior to entering public health, she worked as a reporter for NPR focusing on health policy and politics. Dennis Gallagher, MA, MPA, is an Associate Professor of Health Management and Policy at the Drexel University School of Public Health. Prior to coming to Drexel, Mr. Gallagher had a 27-year career with the U.S. Department of Health and Human Services in management and policy positions. Mr. Gallagher was the principal investigator on Drexel’s studies to assess the feasibility of creating departments of public health in York and Dauphin Counties, Pennsylvania. v Bernard D. Goldstein, MD, is Professor of Environmental and Occupational Health and the former Dean of the University of Pittsburgh’s Graduate School of Public Health. He is a physician, board certified in Internal Medicine, Hematology and Toxicology and a member of the Institute of Medicine (IOM), the American Society for Clinical Investigation, and the Collegium Ramazzini. He is Executive Director and former chair of the National Board of Public Health Examiners. Edward Gracely, PhD, received his doctorate in Quantitative Psychology from Temple University in 1986 and has been a faculty member at MCP, now Drexel University, in the College of Medicine, since then. His research expertise includes the logic of multiple comparisons, statistics education, and ethical philosophy. He serves on the editorial boards of both Pain and Pain Medicine. Deidre J. Holland, MPH, is an Instructor and Fieldwork Coordinator for the Graduate School of Public Health at the University of Medicine and Dentistry of New Jersey. She earned her Bachelor of Science in Health Education and her Master of Public Health from East Stroudsburg University. Previously, Ms. Holland was at the Sussex County Department of Health and Human Services as the Practice Standards Partnership Coordinator under the Local Core Capacity Infrastructure for Public Health Emergency Preparedness grant and served as Chairperson of the County’s Community Health Partnership. Jennifer Kolker, MPH, is an Assistant Professor of Health Management and Policy at the Drexel University School of Public Health. Formerly, Ms. Kolker was the Assistant Director of Policy and Planning for the Philadelphia Department of Public Health and a Senior Policy Consultant for Public Works, LLC, a public policy consulting firm. Ms. Kolker was the principal investigator on Drexel’s studies to assess the feasibility of creating departments of public health in Lancaster and Berks Counties, Pennsylvania. Judith R. Lave, PhD, is Professor of Health Economics, Department Chair of Health Policy and Management, Director of the Health Administration Program, Director of the Pennsylvania Medicaid Policy Center at the University of Pittsburgh, and co-director of the Center for Research on Health Care at the University of Pittsburgh. She received her PhD in economics from Harvard University. She was elected to the Institute of Medicine of the National Academy of Science and the National Academy for Social Insurance and is a distinguished fellow of AcademyHealth. She is vi on the Technical Advisory Group for the Pennsylvania Health Care Cost Containment Council. She is the author of more than 140 scientific publications. Matthew G. Masiello, MD, MPH, is Director, Center for Health Promotion and Disease Prevention, Windber Research Institute and Windber Medical Center. He also serves as Project Coordinator (U.S.) International Health Promoting Hospital Network, World Health Organization Collaborative Center (WHO-CC) Copenhagen, Denmark. Margaret A. Potter, JD, MS, is at the University of Pittsburgh holding positions in the Graduate School of Public Health as Associate Dean for Public Health Practice, Director of the Center for Public Health Practice, and Associate Professor of Health Policy and Management. Her professional interests include capacity building for public health at the state and local levels, training for the public health workforce, and enhancing public and private systems for emergency preparedness and disaster response. vii PREFACE “A Symposium on Public Health in Pennsylvania” is the first policy issue of Commonwealth. It is the fruit of a strong and productive partnership between the Pennsylvania Political Science Association and the Legislative Office for Research Liaison of the Pennsylvania House of Representatives (LORL). In this partnership, LORL has been given responsibility for developing policy issues of Commonwealth using the expertise of faculty members at the more than 100 colleges and universities affiliated with LORL and experts from government and private industry. We are deeply indebted to Margaret A. Potter, JD, MS, Associate Dean and Director, Center for Public Health Practice, University of Pittsburgh Graduate School of Public Health, who served as the editor of this Symposium. Her previous service to the state executive and legislature includes a year-long stint as a LORL Visiting Scholar and many joint policy projects between LORL and the School of Public Health at Pitt. Ms. Potter presently is a University of Pittsburgh Faculty Associate in LORL. The authors of the articles in this Symposium were drawn from the academic, practitioner and consultive communities in public health and from the judiciary. Although the contributors were diverse, they were subjected to the same substantive and methodological standards. Because this is a policy issue, the authors were asked to go beyond their basic findings and to offer policy recommendations derived from their research. These conclusions and recommendations belong to the authors alone and do not necessarily reflect the position, if any, of the Pennsylvania Political Science Association, LORL or the Pennsylvania House of Representatives. Special thanks are due to Barbara Stone, LORL Research Analyst, who did the proofreading and layout work for this volume, and to the House Republican Print Shop, especially Bill Lang and Bill Laughlin, for production and printing. Michael R. King, PhD Associate Editor for Policy Issues and Executive Director, LORL viii ACKNOWLEDGMENTS COMMONWEALTH: A Journal of Political Science Policy Issue “A Symposium on Public Health in Pennsylvania” Associate Editor for Policy Issues: Michael R. King, LORL Special Issue Editor: Margaret A. Potter University of Pittsburgh School of Public Health Editorial Assistant: Barbara Stone, LORL PEER REVIEWERS Michael P. Allswede, Conemaugh Memorial Medical Center Lisa Bowleg, Drexel University Gail S. Cairns, University of Pittsburgh Virginia M. Dato, University of Pittsburgh Rosemarie O’Malley Halt, Working Group for a Delaware County Health Department Christopher Keane, University of Pittsburgh Michael King, Legislative Office for Research Liaison Chyongchiou J. Lin, University of Pittsburgh Beaufort B. Longest, Jr., University of Pittsburgh Gene W. Matthews, University of North Carolina/Chapel Hill Prahlad Murthy, Wilkes University Craig Newschaffer, Drexel University Wade Seibert, Pennsylvania State System of Higher Education Steven E. Shive, East Stroudsburg University Samuel Stebbins, University of Pittsburgh Marleen A. Troy, Wilkes University C. Reynold Verret, Wilkes University ix PENNSYLVANIA POLITICAL SCIENCE ASSOCIATION Officers and Executive Council 2008-09 PRESIDENT Paula Holoviak Kutztown University FIRST VICE PRESIDENT Stanley Berard Lock Haven University TREASURER Thomas Brogan Albright College SECOND VICE PRESIDENT Brooke Harlowe Lock Haven University SECRETARY & WEBMASTER Fran Moran New Jersey City University EXECUTIVE COUNCIL 2006-2009 Term Michael R. King Legislative Office for Research Liaison (LORL) PA House of Representatives Steven Peterson Penn State - Harrisburg 2007-2010 Term Joseph Rish King’s College Michael Dillon LaSalle University 2008-2011 Term Kyle Kreider Wilkes University Joseph Melusky St. Francis University EX OFFICIO MEMBERS PAST PRESIDENT Thomas J. Baldino Wilkes University PAST PRESIDENT Joseph Melusky St. Francis University EDITORIAL STAFF OF COMMONWEALTH: A JOURNAL OF POLITICAL SCIENCE EDITOR-IN-CHIEF Gerard J. Fitzpatrick Ursinus College ASSOCIATE EDITOR & BOOK REVIEW EDITOR Thomas J. Baldino Wilkes University ASSOCIATE EDITOR & SPECIAL ISSUE EDITOR Michael R. King LORL, PA House of Representatives ASSOCIATE EDITOR FOR POLITICAL THEORY Donald G. Tannenbaum Gettysburg College MANAGING EDITOR Michael Cassidy Office of the Democratic Caucus Chairman, PA House of Representatives x LEGISLATIVE OFFICE FOR RESEARCH LIAISON (LORL) Pennsylvania House of Representatives, Harrisburg, PA 17120-2218 Hon. Dennis M.O’Brien The Speaker of the House of Representatives Hon. H. William DeWeese The Majority Leader Hon. Keith R. McCall The Majority Whip Hon. Samuel H. Smith The Minority Leader Hon. David G. Argall The Minority Whip 2007 - 2008 LEGISLATIVE COMMITTEE FOR RESEARCH LIAISON (LCRL) Hon. James R. Roebuck, Jr. LORL Committee Chair Hon. David G. Argall LORL Committee Secretary Hon. Kate Harper Paul S. Cribbens, Esq. Assistant V.P. of Government & Community Affairs and the Director of the Office of Commonwealth Relations University of Pennsylvania Hon. Samuel H. Smith Republican Leader Hon. Marc J. Gergely Hon. Stephen P. Samuelson Dr. Richard L. Rosen Associate Professor History & Politics Department Drexel University Dr. Michael R. King LORL Executive Director 2007 - 2008 UNIVERSITY COMMITTEE FOR RESEARCH LIAISON (UCRL) Dr. Richard L. Rosen Associate Professor of History and Politics Drexel University Dr. Grant D. Venerable, II Vice President for Academic Affairs Lincoln University Dr. Richard DiEugenio Special Assistant to the President for Governmental Affairs The Pennsylvania State University Dr. Michael G. Hagan Director, Institute for Public Affairs Temple University Dr. George E. Klinzing Vice Provost for Research University of Pittsburgh Dr. James Moran Associate Vice Chancellor for Academic and Student Affairs PA State System of Higher Education Mr. Ronald Uroda Vice President for Research AICUP Dr. Andrew Rudczynski Associate Vice President of Finance and Executive Director of Research Services University of Pennsylvania