Above: In preparation for its Special Town Meeting budget request, the Board of Health is seeking to educate the public on the need for funding its ability to provide required “Foundational” public health services. (cropped from Public Health National Center for Innovations materials)
[Editor’s Note: I just learned on Thursday morning that on Tuesday the the BOH agreed to pull its funding request based on the Advisory Committee’s position.
My understanding is that doesn’t mean the positions won’t be funded. But I don’t have the full details to report yet on how they would be. So, stay tuned for a future update and post to clarify what’s happening.
Meanwhile, the content below on the Board of Health’s handout, report and forum are still relevant in terms of their work on behalf of the community and plans going forward.]
The evening of Monday, November 1st, Southborough voters won’t just be asked to vote on zoning changes. There are nine other Articles on the Special Town Meeting Warrant. Today, I’m focusing on the Board of Health funding request.
Despite the labeling of Article 3 as “Amend FY2022 Budget — General Fund/Water”, its main focus* is fully funding public health personnel.
Last year, the Board of Health pushed that it needed increased funding in the FY22 Town budget for the long list of safety responsibilities it has for our town.
After some back and forth, the BOH successfully convinced the Board of Selectmen and Advisory Committee of the funding need. But they were asked to hold off on part of their official budget request to voters until this fall. That allowed the Town to apply for federal funding assistance for July through December.
The Town budgeted for a part-time Public Health Director and Nurse for FY22 and used CARES funding to cover contracts for additional hours. Now, in order to keep the full time staff (for at least through the end of the fiscal year in June), the Town needs to increase the operating budget to fully cover their salaries and provide benefits. That cost is listed as $99,682.
The Board is trying to educate voters to secure support for the ask.
The Town Meeting page on the Town’s website now includes a link for a handout from the Board of Health. It explains:
Article 3 – Funding two full time positions – Regional Approach to Public Health
The BOH is utilizing other town funds to supplement the two full-time permanent positions as listed in the warrant. However, this does not change our vision for core staffing for the future of the Southborough Health Department. Below is a brief overview of current and future needs of the department.
How we got here:
• Pandemic– understaffed
• Utilized funding available through FEMA/CARES in order to meet demands.
• Looking for core staff funding to allow health department to continue current and future workand take advantage of regional opportunities to enhance public health in Southborough.
The flyer goes on to list work that the Board is currently undertaking and a list of future needs to take on. Read that here.
In addition, last week the Board invited the public to an online forum with Dr. Louis Fazen, a former Chair of the BOH. (You can view that here.) Residents were also encouraged to read the report he wrote for the Board “From Invisible to Indispensable (in one pandemic)”. (Click here for the report and a handout on referenced Foundational services.)
The report introduces that in 2019, the Mass legislature responded to the issue that only 3 of 351 local boards of health in the state were found to be meeting national standards. Town boards called on to up their standards based on a commission published “Blueprint” for excellence for providing required “Foundational” services. Just as towns were beginning to respond:
the pandemic abruptly overwhelmed most of the smaller town supported boards of health in Massachusetts, Southborough did the best it could until staffing was reorganized with additional CARES funding. Just as effective immunizations became available, Southborough BOH was staffed to take part with 6 other towns in a highly successful immunization program which saved lives, hospital admissions and many of the Covid-19 sequelae. . . Building on state funding and the momentum of the immunization program, Southborough has joined 3 other towns for a “shared services” grant for specific public health functions. This report outlines the path forward to continue crossjurisdictional agreements so that local health departments can collaborate to attain the well described “Foundational” level of services for all residents in a wider community based health department. . .
This report highlights the possibilities in Southborough for continued development of enhanced local public health with “shared services” and inter-municipal agreements. Thoughtful residents voiced their concerns about the strengths and weaknesses and a guideline with benchmarks is presented within this report for continued development of the Southborough Health Department as well as collaborations between health departments over the next 3 to 5 years. Next steps are up to the residents and leaders to champion the efforts to improve the effectiveness and efficiency of local public health in Southborough.
The report identified strengths of the department, followed by these weaknesses:
- Outside of a pandemic, the role of local public health is invisible. Contact with the BOH is often regulatory related to official duties to collect fees and perform inspections and occasional delays noted.
- Need to document unmet needs for public understanding of public health potential programs. Publicize the vision for healthy outcomes in the community and measure the results.
- The BOH web site and record keeping and historical information lack up to date Information Technology programming. Health data is not available at the local level. Health programming should be data driven to include, for example, injuries by age group, risk taking behavior such as vaping and tobacco use, prevalence of mental health and substance use disorders, housing issues and the list goes on.
- Lack of sustainable funding to attract competent professional staff.
- Lack of 24/7 health staff coverage to effectively work with Public Safety Departments. Public health is part of essential public safety programs for all residents.
- Need improved visibility in town and greater involvement with Emergency Preparedness. Promote healthy messaging on town web site, library and social media.
- Gaps noted in fulfilling all mandated inspections and reporting duties.
It goes on to identify opportunities, threats, and recommended benchmarks by phases.
*While voters are considering that, the Town is also using the Article for a secondary purpose – to tidy up the Water Enterprise Fund budget. (The projection for the fees that the MWRA would assess to Southborough have been lowered by $150,000.)
Updated (10/28/21 8:56 am): See the Editor’s Note at the top of the post.
