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Here’s Lancaster County’s plan to reopen Friday ahead of the governor’s timeline

Commissioners approve economic recovery, public health plans at Wednesday meeting

  • Benjamin Pontz/PA Post
A slide from Penn Medicine Lancaster General Health Chief Clinical Officer Michael Ripchinski's presentation to the Lancaster County Board of Commissioners on May 13, 2020.

Livestream screenshot

A slide from Penn Medicine Lancaster General Health Chief Clinical Officer Michael Ripchinski's presentation to the Lancaster County Board of Commissioners on May 13, 2020.

Livestream screenshot

A slide from Penn Medicine Lancaster General Health Chief Clinical Officer Michael Ripchinski’s presentation to the Lancaster County Board of Commissioners on May 13, 2020.

(Lancaster) — Lancaster County Commissioners took steps Wednesday that its three members agree are critical to public safety and economic recovery amid the pandemic, but sharp disagreements over the pace at which the county should reopen mirrored a debate that has played out in state capitals across the country, including in Harrisburg.

The commission’s two Republicans argued that some businesses can safely reopen now, while its lone Democrat contended it is too early to begin easing restrictions aimed at curtailing the spread of coronavirus.

Over the weekend, Republican commissioners Josh Parsons and Ray D’Agostino joined Republican members of the county’s state legislative delegation, as well as U.S. Rep. Lloyd Smucker (R-11th District) in sending a letter to Gov. Tom Wolf that announced their intent to move Lancaster from the red phase to the yellow phase of the governor’s plan for reopening Pennsylvania, effective this Friday, May 15. Lancaster was among at least a half-dozen counties in which some group of elected officials, mostly Republicans, took similar steps in an effort to accelerate the governor’s schedule.

On Monday, Wolf threatened to withhold federal CARES Act funding from counties that exit the red phase without his administration’s approval, and, since then, many of the counties have recalibrated their approach. But Lancaster can move forward without risking the loss of funds, since the size of its population ensured early access to more than $95 million in CARES Act funding.

At Wednesday’s meeting of the Lancaster County Commissioners, attended by nearly 700 people via video conference, the three-member board engaged in a four-and-a-half hour discussion that grew heated at times about just how quickly the county can safely reopen.

“It’s clear that the county has no legal authority to move from red to yellow,” said Democratic Commissioner Craig Lehman, who argued that the county should wait until it has sufficient testing capacity, personal protective equipment, and contact tracing ability to move forward.

“The [state] guidance is so arbitrary and capricious that it is unenforceable,” countered Parsons, who pointed to a statement from Lancaster County District Attorney Heather Adams stating that she would not prosecute violations of the stay-at-home order and noted that many businesses have already started to reopen.

Lehman decried what he called a “failure” of transparency by Parsons and D’Agostino in not releasing the agenda for Wednesday’s meeting until after 7:00 p.m. Tuesday evening, which Lehman suggested intentionally allowed the pair to load the agenda with items “to cloud the public issue and pretend like Lancaster County is really prepared to reopen when we’re not.”

“You know it is about the political narrative that you are going to try to knit together this week to justify your illegal actions from this weekend, so don’t talk to me about urgency,” Lehman said.

The commissioners eventually discussed and unanimously approved three measures to aid the county’s reopening: a plan to contract with Penn Medicine Lancaster General Health for testing and contact tracing, an economic recovery plan focused on small businesses, and a plan to test nursing home residents and staff and help such facilities improve infection control practices.

Testing and Contact Tracing

Dr. Michael Ripchinski, chief clinical officer for Penn Medicine Lancaster General Health, presented a proposal to conduct up to 1,000 coronavirus tests per day and carry out contact tracing with an estimated capacity of 50 new cases per day. Together, the program would cost the county $24 million over 12 months.

Under the proposal, testing would be limited to those known to have been in contact with someone who has COVID-19 and who exhibit at least one symptom, anyone with two known symptoms, asymptomatic individuals with sustained, high-risk contact with a COVID-19 patient, and special populations such as nursing mothers.

The hospital currently can conduct about 350 tests per day and anticipates soon being able to test between 500 and 600 people daily, Ripchinski said. But it will take time to ramp up to the thousand tests per day this plan envisions.

Still, Ripchinski said that the rate of positive tests — about 10 to 11 percent — suggests that the county has entered the “golden lane” of doing enough testing to give public health officials a good idea of how the epidemic is playing out in the county.

In terms of contact tracing, a process in which health workers identify and contact people with whom a COVID-19 positive individual has been in close proximity to ask them to self-quarantine for 14 days, the hospital plans to increase its current staff of 25 nurses by adding trained community health workers to reach a capacity to trace an average of 50 new cases per day.

“What I like about it is that we’re really being practical about testing,” said D’Agostino. “Having that contact tracing to back up the testing — having both things together — is very important. I like the idea of looking to people that are at risk to get tested. Widespread testing I don’t think is going to be the answer, but being targeted … is going to be extremely important and beneficial to Lancaster County.”

Lehman, still urging caution on the pace of reopening, noted that it will take several weeks to reach the full testing and tracing capacity that the plan envisions, a point that Ripchinski conceded. Ripchinski declined to comment on the broad question of whether Lancaster County was ready to safely move to the yellow phase.

“It’s really not my decision to make. At the end of the day, we’re a health care provider that basically is trying to be a subject matter expert in this pandemic from a science and clinical point,” he said. “Ultimately, it’s not my decision nor health care’s decision to make.”

The commissioners approved a memorandum of understanding between the county and the health system that will set into motion the process of formally entering an agreement in the coming days.

Later in the meeting, the commissioners allocated just over $800,000 to provide a one-time baseline test for the more than 8,000 nursing home residents and workers in Lancaster County. County Public Health Emergency Advisor Edwin Hurston said that any positive results would be forwarded to the hospital system for contact tracing.

The decision to test at the county’s nursing homes came after the Pennsylvania Department of Health changed its guidance earlier this week to recommend that nursing home residents be tested weekly. The Department of Health has begun its testing regime in only two nursing homes statewide, though, so Hurston said he did not anticipate stepping on the state’s toes by approving this plan.

In addition, the commissioners approved about $100,000 to provide the county’s 30 nursing homes the opportunity for an on-site consultation and training with Cocciardi and Associates, a firm that specializes in occupational health and safety, to improve facilities’ infection control practices.

“Conceivably within the next three to four weeks, we could have the testing done and the reviews and supplemental training completed,” said Hurston.

Economic Recovery

Economic Development Company (EDC) President Lisa Riggs and Chamber of Commerce CEO Tom Baldrige presented a $33 million plan to reopen the county’s economy that focuses on distributing grant funds and personal protective equipment (PPE) to small businesses with fewer than 100 employees, with a particular emphasis on businesses with fewer than 20 employees.

“We needed to put together a program and a plan of action to give businesses hope that there is guidance and direction for the future,” said Riggs.

The plan allocates $6 million for the county’s procurement operation to secure masks, gloves, thermometers, and face shields and distribute them, for free, to small businesses in the county.

“We will equip those businesses with free PPE so they can ensure their businesses are operating with the right type of PPE to keep them safe,” said Riggs. “We can’t move fast enough on this line item.”

It will take two to three weeks to secure that equipment; sooner than that — and certainly having it by Friday when the county plans to move to the yellow phase — is not remotely possible, Riggs and Baldrige agreed. Leveraging the county’s size to make a bulk order is the best path forward, they said, because businesses have not been able to get PPE on their own.

“This proposal leverages the power of the county and its purchasing ability in a way that, I think, will greatly enhance the speed with which businesses will be able to get these supplies in order to facilitate their safe continuance,” said Baldrige.

The other major expenditure approved Wednesday is $25 million in grants to small businesses to provide working capital and help them pay for public health retrofitting. To dispense the funds, the plan calls for creating a simple application process that is not first-come, first-served like several federal programs that shut out some of the smallest businesses from being able to access funding.

The EDC, Chamber of Commerce, ASSETS Lancaster, and Community First Fund would review applications for funding and make recommendations. But ultimately, the county commissioners would approve both the guidelines for scoring the applications and the disbursements themselves. Some financial data and proprietary information would need to be withheld from public disclosure, but Lehman emphasized that how each business’s application is graded should be made public to build public confidence in the program.

“There’s no level of transparency that you would put out there that we don’t want to rise to. We are a thousand percent committed — it’s in nobody’s best interests to not have this fully transparent,” Baldrige said.

Similar to the test-and-trace proposal, the commissioners approved a memorandum of understanding that will allow the economic recovery process to move forward, but they did not enter any official contracts at Wednesday’s meeting.

The Path Forward

During the public comment portion of the meeting, the commissioners did not directly answer a series of questions from LNP | LancasterOnline about consultations with the county’s solicitor on the legality of the commissioners’ decision to enter the yellow phase.

Instead, Parsons said that county residents are beginning to “vote with their feet,” with businesses already reopening. D’Agostino added that even counties that have already entered the yellow phase do not have plans as detailed as Lancaster’s to support public health and economic recovery.

“Not one county in the Commonwealth of Pennsylvania is doing anything that we’re doing, so why should we be subjected to a higher standard?” D’Agostino said in a phone call after the meeting. “Smaller businesses can be open now and meet the guidelines put out by the CDC and the DOH.”

Lehman, however, argued that the county still does not have adequate testing, contact tracing, or PPE on hand to reopen safely. He said he would be willing to approach the governor to seek relief if conditions change for the better.

“If you want to withdraw your call to move Lancaster County from red to yellow, if you want to allow for contact tracing and testing capacity to be in place, and you want to get the health system to sign off that there’s no public health risk to reopening … I’m willing to make a request to the governor when all of those things are in place that Lancaster County is ready to move from red to yellow,” said Lehman.

Parsons said that the time to move forward is now.

“There are businesses that can be opening immediately without any higher health risk than we are at currently,” he said. “Any date is arbitrary because we could be in yellow now, safely. That’s my position.”

The author of this piece interned with the Lancaster Housing Opportunity Partnership when D’Agostino was its CEO in the summer of 2018.

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