Local health boards in Berkshire County and statewide, on the front lines during the ongoing COVID-19 pandemic, might be in line for an infusion of state money. That is, if Statehouse lawmakers on Beacon Hill agree on a final version of the measure, as part of the $3.82 billion spending package passed last week by the state Senate.
Why it matters: Under the budget amendment filed by state Sen. Jo Comerford, D-Northampton, who represents Hampshire, Franklin and Worcester counties, local and regional health agencies would be eligible for $95 million in grants aimed at cost-saving shared services by small towns.
That would be on top of $118 million earmarked for public health, according to Senate President Karen Spilka’s office. With the help of the American Rescue Plan Act and state surplus money, the Senate bill includes more than $1 billion in total health care spending.
What’s at stake: Whether local health officials will see the public health reforms included in Comerford’s amendment depends on negotiations underway this week between House and Senate leaders. It’s one of a handful of differences between the bills produced by both sides of the Legislature that have to be reconciled in order to bring a final ARPA spending bill to a vote before a winter recess.
“The goal is to get the bill on the governor’s desk by Thanksgiving,” said state Rep. William “Smitty” Pignatelli, D-Lenox. “I’m very optimistic that things will be ironed out. I’m a big champion of Tri-Town Health.”
The regional agency has served Lee, Lenox and Stockbridge since 1929.
The proposal passed by the state Senate adopts reforms based on a 2019 report from the special commission on local and regional public health. The report urged state and local officials to pay to modernize the local public health system, standardize health reporting, and make sure all local health departments comply with existing regulations and laws.
The commission found that of the 105 towns in Massachusetts with populations of fewer than 5,000, 78 percent lack even a single full-time public health staffer. Because boards are funded with local property taxes, they also reflect existing regional economic gaps, with poorer communities generally spending less on public health.
“In Massachusetts, where you live determines how safe and healthy you are likely to be,” the commission report asserted.
What’s the local impact?: “While we are lucky to work in communities that value our department and public health, others are not so lucky,” said James Wilusz, executive director of Tri-Town Health, which works with seven other towns in the recently formed Southern Berkshire Public Health Collaborative. “There are serious inequities, and a lack of adequate resources and staffing. We need real dollars to build and sustain an even more comprehensive public health system.”
According to Wilusz, “the pandemic has highlighted significant weaknesses in our local public health systems, and now is the time to act and build better regional, smaller and more-efficient systems.”
“The pandemic has showed us all the importance of being able to monitor local population health, to develop, implement and oversee programming to prevent the spread of communicable disease, and to identify and support our community members who are at greatest risk,” said Amy Hardt, lead public nurse for the collaborative.
The additional state money also could benefit the Berkshire Public Health Alliance, overseen by the Berkshire Regional Planning Commission.
When COVID-19 started spreading across Massachusetts, some towns lacked the staff and resources to efficiently contact trace and communicate with state and local officials on the Massachusetts Virtual Epidemiologic Network.
Health inspectors found themselves juggling their local pandemic responses, fast-evolving public health advisories and restrictions from the Baker administration, contact tracing changes, and their day-to-day work monitoring other diseases in their communities.
The bottom line: Under the Senate bill, the state would direct money annually to local boards of health and regional health districts according to population, social and economic data and the existing level of shared services. Local and regional health agencies that are slow to meet the standards set under the reforms could see lower funding levels.
The bill calls for grants to encourage sharing agreements across multiple towns. The grants would supplement, and not replace, existing money that local and regional health agencies receive and would be separate from the annual funding the bill requires.
The Senate plan requires public health experts to develop statewide standards similar to national standards for inspections, epidemiology, communicable disease investigation and reporting, permitting and other local public health responsibilities, along with standards for training, professional development and data reporting. Those experts would include local board of health directors, public health organizations, academic experts, and members of the state’s special commission on local and regional public health.
According to the Senate bill, boards of health would have to prove they are on board with the new standards by submitting a report to the state by Dec. 1every year.
Information from State House News Service, the Boston Business Journal and The Boston Globe was included in this report.