Massachusetts
Massachusetts’ 351 health departments means inefficiency — and unfairness – The Boston Globe
Today, some communities host vaccine clinics and have a nurse available to visit elderly residents. Others have none of that. “It truly does depend on where you live as to what services you are able to avail yourself of,” said Cheryl Sbarra, executive director of the Massachusetts Association of Health Boards.
While most states operate public health services at the county or district level, Massachusetts, with its strong tradition of local control, has left public health up to individual cities and towns, resulting in redundancies, underfunding, and an uneven patchwork of services. Without even standard credentials for public health workers, a 2019 report by a Special Commission on Local and Regional Public Health stated, “Where you live determines not only the depth and breadth of public health protections that are available, but also the qualifications of the individuals providing the services.”
The COVID-19 pandemic drew attention to the system’s inadequacy when the state paid millions of dollars for contact tracing and vaccine clinics, which could potentially have been done by municipal public health officials, had those departments been better resourced and available statewide.
The special commission’s 116-page report lays out a blueprint for reform. Its recommendations include establishing statewide standards for what services public health departments should provide; sharing services across jurisdictions; improving data reporting; establishing standards for public health worker credentials; and distributing funding to help departments meet the new standards.
The Legislature began this work in 2020 by creating a grant program that funds public health staffing and training, including efforts to share services. The Department of Public Health has incentivized communities to work together by offering technical assistance.
Public Health Commissioner Robert Goldstein said from fiscal 2021 to 2023, the state provided $27 million in grants, and over 310 municipalities entered shared service agreements.
Shin-Yi Lao, director of Newton’s public health services, said Newton, Brookline, Belmont, and Arlington are sharing an epidemiologist who analyzes public health data and environmental health specialists who conduct inspections. They are considering collaborating on regional vaccine clinics and reciprocal permitting, so a camp or food truck inspected in one community can operate elsewhere.
The needs for regionalization are often greater in rural communities, which often do not have a strong property tax base to fund public health. At one point, the Franklin Regional Council of Governments was employing one full-time and one part-time staffer to cover the public health needs of 15 Franklin County towns. Grant money has since allowed it to hire more staff. “There was no possibility we could give vaccines, investigate every restaurant, every housing complaint, review every septic plan,” said Phoebe Walker, director of community health for the Franklin Regional Council of Governments.
In December 2021, the Legislature allocated $200 million in American Rescue Plan Act funds to public health infrastructure. Goldstein said the state is spending that money on training, capacity building, and developing performance standards.
The next step is for lawmakers to pass what advocates call the State Action for Public Health Excellence Act, or SAPHE 2.0. The Legislature passed the bill unanimously in July 2022, but then-governor Charlie Baker returned it with an amendment and the bill died. It was reintroduced this session.
The bill would set up a process to implement the 2019 blueprint. This includes developing statewide standards for services provided and workforce credentialing, requiring data reporting, and providing technical support and money through grants and formula-based funding. Money would be contingent on communities moving toward meeting the standards. The bill would support efforts to share services, recognizing that smaller communities would be unlikely to meet the standards by themselves.
Setting minimum standards for workforce credentialing makes sense. The state sets minimum qualifications for building commissioners and library directors. There is a need to ensure that someone inspecting pools, housing, or restaurants is qualified. Goldstein said in some places today, “We’re using a 20th-century public health workforce to operate in the 21st century.”
Data reporting is also vital. As the 2019 report notes, data are a fundamental part of public health, yet Massachusetts cannot answer basic questions like how many foodborne illnesses were traced to restaurants and were those restaurants appropriately inspected?
The Healey administration supports the bill. Goldstein said DPH can write performance standards but only the Legislature can mandate that communities follow them and appropriate money. He called the bill “an important next step for local public health.”
A preliminary cost estimate based on the 2019 blueprint, cited in testimony by the Massachusetts Municipal Association, pegs the cost at $140 million. But that number is outdated and does not consider the COVID relief spending.
The policy would unquestionably require an influx of state money. Lawmakers will have to carefully craft it to avoid placing unfunded mandates on communities and to ensure that more money gets spent on public health, rather than simply having state money supplant local money. But many states, unlike Massachusetts, do pay for public health services. And in the long term, a move toward sharing services will be more efficient than having 351 health departments.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
The Healey administration filed emergency regulations late Tuesday afternoon to implement the controversial law meant to spur greater housing production, after Massachusetts’ highest court struck down the last pass at drafting those rules.
The Supreme Judicial Court upheld the MBTA Communities Act as a constitutional law last week, but said it was “ineffective” until the governor’s Executive Office of Housing and Livable Communities promulgated new guidelines. The court said EOHLC did not follow state law when creating the regulations the first time around, rendering them “presently unenforceable.”
The emergency regulations filed Tuesday are in effect for 90 days. Over the next three months, EOHLC intends to adopt permanent guidelines following a public comment period, before the expiration of the temporary procedures, a release from the office said.
“The emergency regulations do not substantively change the law’s zoning requirements and do not affect any determinations of compliance that have been already issued by EOHLC. The regulations do provide additional time for MBTA communities that failed to meet prior deadlines to come into compliance with the law,” the press release said.
Massachusetts’ Supreme Judicial Court ruled that the state’s attorney general has the power to enforce the MBTA Communities Law, which requires communities near MBTA services to zone for more multifamily housing, but it also ruled that existing guidelines aren’t enforceable.
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The MBTA Communities Act requires 177 municipalities that host or are adjacent to MBTA service to zone for multifamily housing by right in at least one district.
Cities and towns are classified in one of four categories, and there were different compliance deadlines in the original regulations promulgated by EOHLC: host to rapid transit service (deadline of Dec. 31, 2023), host to commuter rail service (deadline of Dec. 31, 2024), adjacent community (deadline of Dec. 31, 2024) and adjacent small town (deadline of Dec. 31, 2025).
Under the emergency regulations, communities that did not meet prior deadlines must submit a new action plan to the state with a plan to comply with the law by 11:59 p.m. on Feb. 13, 2025. These communities will then have until July 14, 2025, to submit a district compliance application to the state.
Communities designated as adjacent small towns still face the Dec. 31, 2025 deadline to adopt compliant zoning.
The town of Needham voted Tuesday on a special referendum over whether to re-zone the town for 3,000 more units of housing under Massachusetts’ MBTA Communities law.
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Like the old version of the guidelines, the new emergency regulations gives EOHLC the right to determine whether a city or town’s zoning provisions to allow for multi-family housing as of right are consistent with certain affordability requirements, and to determine what is a “reasonable size” for the multi-family zoning district.
The filing of emergency regulations comes six days after the SJC decision — though later than the governor’s office originally projected. Healey originally said her team would move to craft new regulations by the end of last week to plug the gap opened up by the ruling.
“These regulations will allow us to continue moving forward with implementation of the MBTA Communities Law, which will increase housing production and lower costs across the state,” Healey said in a statement Tuesday. “These regulations allow communities more time to come into compliance with the law, and we are committed to working with them to advance zoning plans that fit their unique needs.”
A total of 116 communities out of the 177 subject to the law have already adopted multi-family zoning districts to comply with the MBTA Communities Act, according to EOHLC.
Massachusetts
Revere city councilor slams Massachusetts officials for being ‘woke’ after migrant shelter bust
A Revere city councilor says the state’s right-to-shelter law is a “perfect example” of how “woke” ideologies are harmful, as he addressed the arrest of a migrant who allegedly had an AR-15 and 10 pounds of fentanyl at a local hotel.
Originally Published:
Senatory Ed Markey (D-Mass.) is planning to introduce legislation to extend the TikTok ban deadline by 270 days. TikTok has warned of a looming shutdown in just five days, but the new legislation, officially called the Extend the TikTok Deadline Act, would give TikTok more time to divest from its Chinese parent company ByteDance, if approved by Congress.
TikTok is currently expected to “go dark” on January 19, unless the Supreme Court intervenes to delay the ban. The Supreme Court is weighing the ban, and is expected to decide sometime this week whether the law behind the ban violates the First Amendment.
“As the January 19th deadline approaches, TikTok creators and users across the nation are understandably alarmed,” Markey said in a Senate floor speech on Monday. “They are uncertain about the future of the platform, their accounts, and the vibrant online communities they have cultivated. “These communities cannot be replicated on another app. A ban would dismantle a one-of-a-kind informational and cultural ecosystem, silencing millions in the process.”
Markey noted that while TikTok has its problems and poses a “serious risk” to the privacy and mental health of young people, a ban “would impose serious consequences on millions of Americans who depend on the app for social connections and their economic livelihood.”
Markey and Senator Rand Paul (R-Ky.), along with Congressman Ro Khanna (CA-17), recently submitted a bipartisan amicus brief urging the Supreme Court to reverse the D.C. Circuit Court’s decision that upheld the TikTok ban. The trio argued that the TikTok ban conflicts with the First Amendment.
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