Board of Health notes: Budget and staffing issues; Flu clinic plans

The Board of Health was one of the departments charged with providing reduced versions of budgets for the fiscal year starting in June.* At last week’s meeting, the Board was already dealing with financial impacts of pandemic responsibilities at their current funding level.

During last Thursday morning’s BOH meeting, members discussed the issues. They also addressed plans for handling this fall’s Flu Clinic.

Flu Clinic

The Town has already ordered 240 doses of the flu vaccine, but has the flexibility to increase or reduce that. The number is 20% higher than last year, based on an assumption that demand will be higher this fall. 

Following their established Emergency Preparedness Plan, the clinic will be held in the Woodward School gym. It will be coordinated with Southborough Emergency Management and support is expected from members of MRC (Medical Reserves Corp) and CERT (Community Emergency Response Team).

Equipment and budget

In the meeting, the Board voted to purchase a work cell phone for the new Public Health Nurse. Leading up to that was long discussion about the lack of money in the budget. 

The nurse has been responsible for monitoring infected and contact traced residents. Last Thursday morning, Nurse Emily Amico reported there were 35 infected cases (12 still-then active) and 64 residents had been quarantined (15 still were at that time.)

Amico has been doing the work from home without a Town provided cell phone, and, until recently, with a problematic laptop.

To protect the privacy of her personal numbers, Amica hasn’t used her cell to call or text. She’s been calling from her landline after blocking caller ID  (by dialing *67). Amico acknowledged that many people are more likely to answer texts than phone calls or emails. Chair Marylou Woodford noted that many people don’t answer a call from a blocked number. 

Because the former nurse had used one cell for both personal and work calls, there wasn’t money budgeted for a phone for the nurse. Staff indicated that the Finance Team told them to hold their request for a new phone until the end of June. (There was also mention of the budget exercise.)*

Woodford stressed that the current situation is very different from past years. Much of Amico’s work depends on communicating with the public. Member Dan O’Rourke said he thought the reason they signed off on a State of Emergency was for needed funding.

There was reference to possible funding through the Board’s Revolving fund for vaccines and emergencies. Administrative Asst. Barbara Spiri warned that the amount in the fund had been lowered by the department’s need to purchase a fridge. They did recently get a vaccine reimbursement. Chamberlin reminded that the up-front cost for purchasing high dose flu vaccines for the fall clinic is high and reimbursements can be slow. 

In context of following the Town’s directives on the budget, Public Health Director Pisinski reminded the Board that they were independently elected. He said they were only required to “coordinate” with the chief executive and voters have been supportive of public health.

Woodford moved to approve purchasing a phone to be reimbursed and, if necessary, a laptop. The Board agreed.

Earlier, Pisinski gave thanks to IT Manager Tom Laflamme for switching over his laptop to Amica. Woodford was concerned about the impact of a slow computer on Amica’s workload.  Laflamme clarified that the laptop Amico just received was only a year old. She confirmed that while she had just gotten setup on it the night prior, it appeared to be fine. 

Laflamme confirmed that if his budget passes at Town Meeting, a new laptop would be prioritized for the dept in July. In the meantime, he didn’t seem to think a new one was required for Pisinski. Woodford said the “if necessary” vote was to allow Laflamme, Amica and Pisinski to determine if something more is needed.

Staff burden

When the Board hired Amico in March her position was listed as 15 hours. Since taking over the job in mid-April, she has been working closer to 40 hrs/wk.

Amico asked the Board if they had a plan for how to handle her hours going forward. The Board will address that at next month’s meeting. By then, Woodford hopes that Amico will have a better idea of what her workload will look like heading into the summer.

Spiri noted that the department could only increase Amico’s hours to 4o for up to 90 days. After that, they would have to create a new full time position. 

Amico hoped she was on track to lower her hours to 30. She had started being able to delegate more of the quarantine follow up to Southborough School nurse. Former Public Health Nurse Leslie Chamberlin asked if the nurses are paid to work year round or only until June. No one knew.

Asked her ideal situation going forward, Amico seemed unsure. She said she had thought that a combined 30 hours through her two part-time jobs was ideal. Because she couldn’t handle more than 40 hours with her home situation, she hadn’t worked for Sudbury the past three weeks. Since she wanted to retain oversight control of Southborough’s situation, she was uncomfortable with the suggestion that she might want to cap hours at 20/week.

Woodford pointed Amico to look into possibly using the state appointed Contact Tracing Collaborative to help. She said that Framingham (which has much higher numbers) had started using the CTC on a small number of cases.

The Chair said a plus was that CTC staff includes people who speak different languages. But she also indicated that the Framingham nurse was trying to vet how diligent CTC was before delegating more to them. She said they’d get a better indication in the next few weeks. It would be a no cost option.

Public Health Director Paul Pisinski agreed that they should talk more at the next meeting. He noted that even 30 hours was a full time, benefited position. If the Board wanted to pursue that, it would require going to the Personnel Board and then Town Meeting.  

Amico pointed out that under the State of Emergency, FEMA is reimbursing for 75% of her extra hours. If the position was rewritten to increase her hours, those hours wouldn’t be reimbursable.

Chamberlin has been working for the Senior Center. She indicated that he has been and would continue to be able to give some of that time to support public health.

*The “exercise” is asking departments to cut budgets lower than their pre-pandemic budget requests. Selectmen plan to look at what it would take to avoid a tax increase this year or cap it at a 2% increase.