Creating a 21st-Century Local Public Health System

The COVID-19 pandemic has shown that the local public health system in Massachusetts is not adequately structured, staffed, or financed to meet large scale public health challenges. Despite the dedication of our state’s local public health workforce, the Commonwealth’s decentralized approach to delivering public health services leads to extreme variability across municipalities — and this puts the entire state at risk. It’s time for Massachusetts to create a 21st-century local and regional public health system that can meet the challenges of today – and tomorrow.

The SAPHE 2.0 Coalition

In response to the challenges faced during the COVID-19 pandemic by hundreds of municipal public health departments and boards of health in Massachusetts, MPHA and a broad coalition of partners have formed the SAPHE 2.0 Coalition. Together, we are calling on state leaders to take urgent action to transform the local public health system in Massachusetts.

The SAPHE 2.0 Coalition is led by municipal officials and public health experts. In 2021, the Coalition successfully advocated for the allocation of $200M in federal ARPA funds over five years to:

  • Establish integrated, 21st 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.

Massachusetts is in the midst of transforming our local public health system. Passing the Statewide Accelerated Public Health for Every Community Act (SAPHE 2.0) is the next step. SAPHE 2.0 provides the roadmap for the legislature’s $200M ARPA investment in local and regional public health and contains the critical policy solutions needed to realize a truly equitable and efficient local public health system. This critical bill, filed by Rep. Hannah Kane, Rep. Denise Garlick, and Sen. Jo Comerford, will: 

  • Ensure minimum public health standards for every community,
  • Increase capacity and effectiveness by encouraging municipalities to share services,
  • Create a uniform data collection and reporting system, and
  • Establish a sustainable state funding mechanism to support local boards of health and regional health departments.

Click here to view the SAPHE 2.0 Bill Fact Sheet

Implementing Unanimous Recommendations

The SAPHE 2.0 Act is based on the consensus findings of the Special Commission on Local and Regional Health. It would also implement a key recommendation from the final report of the Joint Committee on COVID-19, Emergency Preparedness and Management. The bill directs the Department of Public Health to establish minimum standards for local public health departments and boards of health and sets out a clear timeline for communities to reach those standards. SAPHE 2.0 also establishes state funding to support communities in reaching these benchmarks, while also providing incentives to encourage communities to share services. Finally, it creates a uniform data collection and reporting system to track statewide progress and ensure that our public health responses can be made based on accurate and consistent data.

SAPHE 2.0 also builds on the progress made through passage of the original SAPHE Act, which is now in statute as Chapter 72 of the Acts of 2020, An Act Relative to Strengthening the Local and Regional Public Health System. This legislation created a voluntary grant-based program as a first step towards improving the local public health system.

The COVID-19 pandemic has laid bare the inadequacies of our local public health system. The status quo is not only unacceptable, it is dangerous. Now is the time to invest in creating a stronger, more equitable system that will provide essential public health protections to all residents — regardless of race, income or zip code!

For more information, contact MPHA’s Deputy Director, Oami Amarasingham at

In the News:
Additional Resources:

Fact Sheets

Testimony and Letters



6/9/2021 No More Band-Aids State House Rally

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