The Montgomery County Council this week approved a plan that outlines the health care needs and goals for the county for the next five years.
This is the first time the County Council has approved a health services plan, and the approval came despite objections from County Executive James P. Gleason and the county school board. Wanting more public hearings and more time to make recommendations, Gleason and the school board had asked for a delay in voting on the plan.
"If we go to public hearing," said council member John Menke, "we'll get lots of heat and not much light on the issue. I'm not sure we'll get much out of (hearings)."
The school board passed a resolution at its meeting Tuesday, several hours before the council took action, requesting the county council "take no action having implications for the school system" until the board could "study, analyze and take positions" on the health plan.
The county health services planners, who designed the plan, held a public hearing on the plan in May. "We talked with members of the school system," said Frank Ortega, chairman of the Health Services Planning Board, "but I can't say we talked with the school board."
The five-year plan sets out how health services should be delivered.It specifies how hospitals should be staffed and recommends the number of beds that should be provided in various pediatric, psychiatric, obstetric and intensive care units of the county's four hospitals and one under construction (the Shady Grove Adventist Hospital).
When some 200 regional health systems agencies were created by the federal government a year and a half ago, Montgomery County was one of the few areas in the country designated as a "health planning area" without crossing county lines.
The county argued that the County Council, which was designated the Health Systems Agency for its area, should have final approval and veto powers over any plans of the 23-member Health Services Planning Board.The federal Department of Health, Education and Welfare, arguing that the council should relinquish all its powers to approve or reject the plan to the planning board, threatened to withhold funds from the county.
In February 1977 the county filed suit, and in April of this year a federal district judge ruled in favor of the county and returned to the council the power to reject or approve a health service plan.
A one-year implementation plan also was approved this week by the council. The planning board had targeted education on nutrition and alcohol usage as high-priority health care concerns. However, the council said it would not approve those priorities in the plan.
The council also said it would not endorse any spending, above what is already budgeted for the current fiscal year, on health needs requested by the planning board. The planning board had asked for $150,000 for nutritionists.
"The housing people want more money," said council member William Colman, "The transportation people want more money. Everybody wants more money. And there's a little thing called Proposition 13 around that might mean this might not be a propitious time to increase the number of nutritionists from two to 12."
"And we're not even sure that increasing the number of nutritionists," said council member Menke, "will be better for health in the county, anyway."
The plan requires HEW approval, but county officials said they consider the plan in effect now.