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After decades of contemplation and debate, a group known as Better Together is recommending an end to the “Great Divorce” between St. Louis and St. Louis County.Better Together is proposing an ambitious plan to create a unified metro government and police department and limit municipalities' ability to levy sales taxes. The plan would be decided through a statewide vote.Proponents contend it will scrape away layers of local government that has been holding the St. Louis region back. Opponents believe the plan will create an unwieldy and large centralized government that could be implemented against the will of city and county residents.

'Better Together' Seeks to Streamline Public Health Services

Dr. Farouk
Flickr Creative Commons

Like many municipal services, the St. Louis City and County Departments of Health operate separately.

Although the city and county collaborate and serve many of the same purposes, the divide may make it more difficult for the agencies to help residents. That's according to a report released Wednesday by the group ‘Better Together,’ a project that is exploring whether or not St. Louis county and city should consider altering merging various services.

Combining the city and county health departments into a regional entity would save money, cut down on the duplication of services and help departments collaborate across city and county lines, according to study author Dr. William Ross.

As detailed in the report, the city’s Department of Health relies on grants and contracts for 51.5 percent of its budget. In contrast, the county’s department takes the majority of its funding from property taxes, through a 0.14-cent per $100 assessed valuation.

“As a combined entity, we would be much more effective in garnering federal support, rather than providing--in some cases--competing grants,” Ross said. Ross chairs Better Together’s Public Health Committee and is the Associate Dean for Diversity at the Washington University School of Medicine.

Ross said combining the departments would reduce overhead costs, such as administration and some staffing.

“When both health departments are not awash in excess funding, it’s necessary to realize the great economies of scale from sharing services, and to improve efficiency of operations,” Ross said.

Because the city and county departments keep separate data, Ross said their ability to address public health concerns, such as sexually transmitted infections, isn't as efficient as it could be if the efforts were merged.  

The Public Health installment is the third of six reports for the 16-month ‘Better Together’ project, which is funded by the Missouri Council for a Better Economy. The organization’s website says it is not advocating a specific plan to combine services in St. Louis City and County, but seeks to act as a source of information for those discussions.    

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