Commonwealth Court Senior Judge Keith Quigley on Thursday rejected the union's bid for a preliminary injunction to stop the closure of 26 clinics - virtually all in rural areas - even as its suit to halt the plan remains under consideration by the court.
"This plan puts public health at greater risk because it reduces the amount of public health-care workers in a state that is already the lowest in the amount per capita nationally and removes a local presence the community will have in times of a public health-care crisis," said Kevin Hefty, vice president of SEIU Health Care Pennsylvania, the lead plaintiff, which represents 160 public health nurses.
The plaintiffs say they will press on even as the administration moves to revamp health access in rural areas by putting nurses on the road and delivering services such as vaccinations through health fairs and other events rather than brick-and-mortar clinics.
"We believe the state health center modernization will bring vital services to more people throughout the commonwealth," said Department of Health spokeswoman Aimee Tysarczyk. "We will move ahead with our plans to put a system in place that allows us to best serve our communities and will meet Pennsylvania's changing and growing public health needs."
Under the plan, which trims $3.4 million from the $20 million budget that supports the 60 clinics, the full complement of clinic nurses would remain, but they would be based in consolidated district offices, which could be many miles apart, Tysarczyk said.
The SEIU says three nurse consultants would be laid off from the Reading district office, which serves Berks, Delaware, Schuylkill and Lancaster Counties, but the state would not confirm that number, nor would it confirm more than 26 layoffs overall.
The only clinic in the Southeast, located in Chester City, would remain open. The move would not affect city and county-run health centers in Bucks, Chester, Montgomery and Philadelphia Counties.
Jon Ann Fredericks, a nurse consultant in Reading who handles tuberculosis cases, said the clinics provide core health services to the uninsured, such as immunizations.
"Asking those folks to travel longer distances without transportation is a hardship for them," said Fredericks. Public health advocates, along with several Democratic legislators who joined the suit, argue that the closures would further limit access to care in a state already ranked by the Robert Wood Johnson Foundation in the bottom tier nationally for its public health system.
Public health nurses make sure new mothers have an infant car seat and a crib, and serve as the liaison, for instance, with Amish communities to encourage vaccinations, said Hefty, the union official.
"This isn't someone saying 'Hi, I'm from Harrisburg here to help you,' " he said. "These are people who know the community, and having a relationship with the community is the only thing that works."
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