GREENFIELD — As the state mulls if it needs to overhaul parts of its uniquely decentralized health system, a handful of members of local boards of health spoke in support of more assistance from the state to help them better do their jobs and serve their communities.
While no concrete changes to the model of public health in the state should be expected in the near future, the state’s Special Commission on Local and Regional Public Health is in the nitty-gritty process of figuring out what specific recommendations it should make to the Gov. Baker administration and the Legislature — and that’s why they’re going across the state, looking for input based on its May status report.
The meeting Monday held at the John Olver Transit Center was the first of six listening sessions across Massachusetts and the lone one in a rural county and one of two in western part of the state, with the other coming in Westfield, June 15.
Currently in Massachusetts, unlike in many states across the country, each town or city — all 351 of them — has its own board of health, and in some of those towns, it is the sole responsibility of that town to provide adequate health services for its residents.
In 2016, a group of invested parties from both the public and private sector formed to examine this model of municipal health care. Last month, the Special Commission on Local and Regional Public Health released its big draft report that mostly indicates the need to assess the decentralized system that tries to serve complex needs, with little to no public evaluation. It also calls for more credentialed health agents in towns.
A brief overview of the report and what the commission is looking for was presented by Erica Piedade, the director of Local Public Health Initiatives for the state Office on Local and Regional Public Health, which is a division under the Department of Public Health.
While there are a lot of layers to the bureaucracy involved with potentially shaping the future of the public health in the state, locals working with town public health in Franklin and Hampshire counties made it clear the current model is not sustainable.
These thoughts were heard both by Piedade and local representative on the commission, the Franklin Regional Council of Governments’ Phoebe Walker, who is the voice for towns with under 5,000 residents.
Walker said “the concept of every person in Massachusetts having a right to foundational public health services and standard workforce credentials for the public health workforce,” were points she heard from those who spoke.
“There’s still lots of work to be done both in terms of finance and structure,” said Walker. “Nobody can do (these changes) without more money.”
The state may need to fund local boards of public health or provide additional access to regional services, like health inspectors, to make things both realistic and have the chance to be sufficiently healthy.
“Even in a very well endowed town, and I’m not complaining, I think we could use some help,” Longmeadow Health Director Beverly Hirschhorn said.
Hirschhorn, who spoke after a few hilltown health agents, said Longmeadow, a “town of 16,000 must sound like a major metropolis,” but with its relatively well-off finances and the size of its population, it still is challenged to provide adequate health to its residents.
“From my perspective of over 30 years, I don’t understand why Massachusetts has pockets of third-world health care as far as I can see,” she said, advocating for the special commission’s report.
Heath’s Board of Health Chairwoman Betsy Kovacs said the regionalization model her town is a part of through the Franklin Regional Council of Governments is “highly successful and should be used as a model.”
The biggest issue people had was with implementation, saying it’s great that health agents should be credentialed, but these trainings need to be offered in western Mass. Leyden’s Board of Health Chairwoman Kathie Benson said these trainings need to be in-person, too, because to offer them online is not necessarily helpful in the hilltowns without broadband internet.
Doug Telling, Charlemont’s Board of Health co-chairman, said, “I’d like to recommend the state help people set up regional districts” for public health. He added it can be helpful to have professional health agents who aren’t from the town come in and do their work to avoid “petty feuds” that can be a part of small-town politics.
Amherst’s Health Director Julie Federman, a registered nurse, asked for the special commission to consider how the state can finance local boards of health better.
“I’m sure nobody at the state is excited that a little bit of minimal funding for each community would raise the bar for communities,” Federman said.
Reach Joshua Solomon at:
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