Whether you live in a major city or the smallest town, your local board of health has statutory responsibility to address infectious diseases – like COVID-19 – by administering vaccines, investigating known and suspected cases, recommending quarantine and isolation, reporting to state public health officials, and enforcing regulations around reopening. They are also responsible for protecting residents from a wide variety of other threats, including foodborne illness, water contamination and lead poisoning. Every day, our local public health departments are working behind-the-scenes to keep us safe.

The Problem

The difficulty that we face in Massachusetts is the inconsistency in capacity and quality of local public health departments. The municipal approach to public health in our state – through 351 cities and towns – means that there is substantial inefficiency and redundancy, as well as variability in service delivery. In particular, many small towns lack staff and instead rely entirely on volunteer boards of health. As a result they lack the capacity to meet the new demands being placed on them as a result of the current epidemic. MPHA has been working to address this challenge for years, by founding the Coalition for Local Public Health, advocating for legislation to create the Special Commission on Local & Regional Health, and leading the successful campaign to pass the SAPHE Act. But more must be done to ensure that every Massachusetts resident benefits from strong public health protections.

Meeting the Immediate Challenges of COVID-19

During the first wave of COVID-19, MPHA played a critical coordination role, connecting the state’s COVID-19 Command Center with local public health departments and districts. Together with our partners in the Coalition for Local Public Health, we developed a network of seven Crisis Affiliates, who were collectively responsible for supporting and directing state resources to local health departments in 227 municipalities. These Crisis Affiliates included regional planning organizations and public health umbrella groups. In addition, MPHA worked with our partners to identify critical unmet needs at the local level and advocated for additional support and resources from the State.

Early in the pandemic, we also partnered with public health programs at nine colleges and universities (Northeastern, Boston University, Tufts, Harvard, UMass Lowell, UMass Amherst, Simmons University, Regis College, and the Mass College of Pharmacy and Health Sciences) to recruit students, faculty, and alumni as volunteer contact tracers. Nearly 2,000 volunteers registered through what is now called the Academic Public Health Volunteer Corps, and hundreds of volunteers were matched with Massachusetts communities.

Accelerating Improvements to the Local Public Health System

Despite the dedication of our state’s local health staff and volunteers, the COVID-19 pandemic has revealed the dangerous inadequacy of our municipally-based local public health system. Now is the time to move rapidly to transform this system to protect public health and safety during the remainder of the COVID-19 crisis and to meet future threats to public health.

MPHA is currently working with a coalition of public health leaders, elected officials, and organizations to create a 21st-century local public health system in Massachusetts by 1) allocating federal funds from the American Rescue Plan Act of 2021 (ARPA) and 2) passing the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0).

Investing Federal Funds to Transform Local Public Health

Thanks to the tireless advocacy of public health advocates across the state, the Legislature and Governor Baker recently allocated $200M in federal ARPA funds to transform the Commonwealth’s local public health system! We are deeply grateful for the strong support of the House and Senate leadership and the steadfast commitment of our legislative champions – State Senator Jo Comerford, Vice Chair Denise Garlick, and State Representative Hannah Kane – in helping us reach this historic milestone. The funds will be used over the next five years to:

• Establish integrated, 21^st century data systems,
• Invest in workforce development to ensure that every community benefits from the expertise of trained professionals, and 
• Eliminate the significant inequities in public health services and capacity between municipalities.

We now look forward to working with the House & Senate to ensure that these funds are used efficiently by passing the complementary policy solutions contained in the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0). Together, we will build a local health system that equitably serves ALL residents – regardless of their race, income or zip code!

Implementing Policy Solutions

In addition to allocating federal funds, the Legislature must also institute structural reforms by passing the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0). This critical legislation would build on the consensus recommendations of the Special Commission on Local and Regional Health by:

• Establishing Minimum Public Health Standards for Every Community,
• Incentivizing Municipalities to Share Services,
• Creating a Uniform Data Collection and Reporting System, and
• Providing Sustainable State Funding.

Massachusetts deserves a public health system that provides ALL residents with high-quality public health protections. To learn more, click here.