Supporting Local Health Departments

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 and enforcing 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 inadequacies and inequities of our municipally-based local public health system — and this puts the entire state at risk. Now is the time to move rapidly to transform our system to adequately 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 urge the Legislature to 1) allocate $250.9M in federal dollars from the American Rescue Plan Act of 2021 (ARPA) to creating a 21st-century local public health system in Massachusetts, and 2) pass the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0).

Investing Federal Funding in Local Public Health

The time has come to transform the Commonwealth’s inefficient and inequitable local public health system! MPHA and our partners in the Coalition for Local Public Health are asking the Legislature to allocate $250.9M in federal dollars from the American Rescue Plan Act of 2021 (ARPA) over the next five years to local public health, in order to:

  • Invest in local public health infrastructure to address health disparities,
  • Enhance public health data systems, and
  • Support workforce development and training.

This request represents less than 5% of the $5.3B in ARPA funds coming to Massachusetts. By making this investment, we can take advantage of this once-in-a-generation opportunity to create a 21st-century local public health system.

Passing the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0)

In addition to allocating an infusion of 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,
  • Increasing Capacity and Effectiveness by Encouraging 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 – regardless of their race, income or ZIP Code. To learn more, click here.

Additional resources for local health departments can be found at the following websites:

If you are a local Health Department staff member or volunteer needing assistance, please contact Kristina Kimani at kkimani@mapublichealth.org.

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