A Health Chief's Shift From Big-City Ills

New Official Says Howard's Needs, Though Subtler Than Baltimore's, Still Pose a Test

Peter L. Beilenson, Howard's new health officer, is concerned about the county's growing number of people without insurance and the treatment of addicts. (By Katherine Frey -- The Washington Post)

Passionate and outspoken, Peter L. Beilenson fought AIDS, addiction and other plagues when he served as Baltimore's health commissioner. Now, as Howard County's new health officer, he is poised to translate the lessons of a big city's health crisis to the subtler needs of an affluent suburb.

"I went from the fifth-poorest jurisdiction in the United States to the fourth-wealthiest county in the United States," he said in an interview this week.

Yet he is convinced there will be plenty of challenges ahead.

Beilenson, 47, served as the city's health commissioner for 13 years before resigning last year to run for Congress. He had been mentioned as a possible top state health official in Gov. Martin O'Malley's administration. Beilenson said he was recruited for the Howard job by County Executive Ken Ulman (D), who has said he wants to make the county "the model public health community of the United States."

Early next month, Beilenson plans to help unveil the Healthy Howard Initiative. Although few details have been revealed, Beilenson said this week that the program will offer incentives to county schools, restaurants, workplaces and recreation councils that promote better diets, exercise and disease prevention.

Along with four other Maryland counties and Baltimore, Howard has enacted restrictions on smoking in bars and restaurants.

With its highly educated workforce, Howard should be leading Maryland and the nation on a range of public health issues, Beilenson said. He sees his new position as a chance to push for change.

"The status quo is not acceptable. Not in this county and not in this state," he said.

Meanwhile, Ulman is counting on Beilenson to fulfill his expectations for the county.

"I consider Dr. Beilenson to be, literally, the best health commissioner in the state and the best health officer in the country," Ulman said this month in announcing Beilenson's appointment.

Although Beilenson, his wife, Chris, a social worker, and his five children live in Baltimore, he said Howard is not unknown territory to him. He got to know many of the county's leaders when he ran for the 3rd District congressional seat to succeed Benjamin L. Cardin (D), who was elected to the Senate. Beilenson, whose father, Anthony Beilenson, was a longtime congressman from California, lost in November to John Sarbanes (D), son of former Maryland senator Paul S. Sarbanes (D). Beilenson said he has no other political plans.

As Howard's health officer, Beilenson said he won't forget the lessons of Baltimore and the years he spent focused on damage control, such as finding ways to stem the spread of HIV among the city's 40,000 to 45,000 addicts.

"In the city, we were focused upon acute public health issues, drugs . . . sexually transmitted diseases, teen births . . . juvenile violence. Some of that occurs here," he said. "This is not utopia."

Beilenson believes there are between 6,000 and 8,000 addicts in Howard and sees a growing need for treatment. Efforts to open methadone clinics in Columbia and Elkridge several years ago met with fierce neighborhood resistance. So Beilenson is hoping that more physicians will begin prescribing the relatively new drug buprenorphine to treat people addicted to heroin or prescription painkillers.

"It relieves the obstacle of NIMBY," he said.

He also has been struck by the growing number of people without health insurance in Howard and throughout Maryland. "It's the working poor and, more and more, the working class," he said.

Beilenson favors a plan to raise the cigarette tax to pay for expanded Medicaid services. But ultimately, Beilenson, a longtime statewide leader on the issue of universal health care, would like to see all Marylanders covered by insurance. He likes the approach by Democratic presidential candidate John Edwards to require employers to provide insurance or pay into a fund that would help people buy their own.

"So many small businesses are not providing health insurance," Beilenson said. "It's a real tragedy in a state as wealthy as ours. We should be leading. "