HARRISBURG, Pa. (AP) - Gov. Tom Corbett's Department of Health wants to close nearly half of Pennsylvania's 60 health centers - including one in Carbon County - and lay off some nurses as part of an effort to save money and improve the way the state handles its public health duties, officials said.

The plan would keep 34 health centers and eliminate the positions of 26 nurses who perform services that are handled by other agencies. More emphasis would be placed on nurses traveling to public gatherings as a way to administer things like immunizations and, ultimately, serve more people, department spokeswoman Aimee Tysarczyk said Monday.Tysarczyk said the department could name only some of the health centers it wants to close because of agreements to notify the labor unions first. But she said health centers in Beaver, Blair, Carbon, Fulton, Mifflin, Potter and Somerset counties would close.The union also said health centers in Adams, Armstrong, Clinton, Columbia, Crawford, Forest, Greene, Jefferson, Lawrence, McKean, Montour, Perry, Pike, Snyder, Susquehanna, Union, Wyoming counties would close, as would health centers in Monessen in Westmoreland County and Wilkes-Barre in Luzerne County.The 26 nursing positions to be eliminated include nurses in district offices who largely work on chronic diseases, maternal health and school health, Tysarczyk said. Twenty-four other employees, including 14 clerk typists in the health centers, would also lose their jobs, she said."We just want to make sure we're reaching the people who have the most need," Tysarczyk said.Tysarczyk said 104 community health nurses, along with 18 community health nurse supervisors, would remain on the job - some moving into newly consolidated centers - and focused on four core services: communicable diseases, disease investigations, immunizations and tuberculosis screening and case management.The labor union that represents state nurses said the move runs the risk of slowing down the detection or prevention of outbreaks of communicable diseases and will be felt most heavily in rural areas.The union, SEIU Healthcare Pennsylvania, also points out that Pennsylvania has fewer public health workers per capita than most other states and suggests that closing the centers may violate a 1996 state law that says the Legislature's approval is necessary.In 1996, then-Gov. Tom Ridge proposed having private companies take over the health centers - some dating back to the early 1900s - and the state public health laboratory as a way to save money. An administration spokesman at the time said the current system was a relic from the days when medical professionals made house calls because sick people were quarantined at home.Lawmakers rejected the idea amid worries over whether contractors would be aggressive in following up on public health problems and how the poor, elderly or migrant workers would reach the dramatically consolidated services. The Legislature then passed a law that prevented the full-scale plan, but allowed a one-year privatization pilot.Since then, the size of the nursing staff at the health centers has dwindled, said Marshall Deasy, an infectious disease and epidemiology program specialist with the Department of Health.Deasy, who is a member of SEIU Healthcare Pennsylvania, said it makes no sense to do away with central points where people can come see a nurse while forcing nurses to drive across counties every day either to see patients, pick up immunizations or simply get home.The centers are well-known in their communities, and the nurses there do everything from testing for HIV, administering routine vital signs tests to the elderly or taking communicable-disease reports from local doctors' offices, Deasy said."People come in here covered with lice and they can't put their kids back into school until they deal with that and the nurses personally help them," Deasy said.The 60 health centers cost about $20 million to run. The closures would save $3.4 million, according to the health department.