Research

Massachusetts Public Health Regionalization Project
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 UPDATE: from the MA Public Health Regionalization Project Working Group
Senate Bill 2568, “An Act Relative to Public Health Regionalization in the Commonwealth” (as amended) was reported out of the Health Care Finance Committee favorably on April 30, 2008. A brief summary of the bill can be found below. (For those who follow legislation by other methods, please note that this amended version is the only valid version. Versions on Instatrac and on the mass.gov website are the original versions, not the amended version.)

This bill is the result of hard work by many, but especially Cheryl Sbarra and Laura Richards of MAHB. Relying upon feedback from local health officials around the state, the Working Group was able to work with the leadership of both the Joint Committee on Health Care Financing and the Joint Committee on Public Health to craft a bill that addresses the questions and concerns of local public health officials.

Summary of amendments

Ch. 111, §27A

  • Authorizes cities as well as towns to be able to share health directors and other staff.
  • Adds a provision that persons newly hired after the effective date, shall meet the qualifications for their positions as may be established by regulation of the Department of Public Health (DPH) and the Department of Environmental Protection (DEP.
Ch. 111, §27B

  • Adds provision for part-time employees; both full and part-time employees brought in under the district to maintain civil service status, retirement and/or any other rights and/or benefits, as well as his/her current compensation rate.
  • Adds the requirement that joining a district requires a vote of the Board of Health in addition to city council or town meeting.
  • Adds a provision to retain local legal authority (home rule) after a district is formed.
  • Adds a provision that persons newly hired after the effective date, not those employees brought under the district as discussed above, shall meet the qualifications for their positions as may be established by regulation of the Department of Public Health (DPH) and the Department of Environmental Protection (DEP).
Ch. 111, §27C

  • Adds a provision, subject to appropriation by the State Legislature, to provide state funds for operating expenses.  The amount of funds shall be established by a formula that includes the requirement of municipal matching funds..Monies received pursuant to this section would be IN ADDITION to those funds that are provided through municipal budgets.

Massachusetts Public Health Regionalization Project goal:
To strengthen the Massachusetts public health system by creating a state-funded regional structure for equitable delivery of local public health services across the Commonwealth

Guiding Principles:
  • The system must respect existing legal authority of local boards of health
  • As a voluntary initiative communities need incentives not mandates to participate
  • One size does not fit all; different models of regional structures and operations will allow communities to cluster in ways that will meet their needs
  • The system will require adequate and sustained state funding
  • The system will augment, not reduce, the existing local public health workforce
Critical Elements:
  1. Providing the ten essential public health services to ALL residents of Massachusetts through an integrated public health system that offers a legal foundation, governance structures, and financial incentives for forming regions.
  2. Clarifying the roles and responsibilities at local, regional and state agency levels to strengthen and support an integrated system.
  3. Establishing standards for local, regional and state performance including: workforce credentials; performance measures and agency accreditation.
  4. Recommending a system to routinely deliver comprehensive training programs for the local public health workforce. Training activities must be coordinated with performance standards and measures and include supervised field training.
Progress to Date:
  • Our initial work was guided by a Steering Committee with over 40 members from across the state, which held meetings in 2005 and 2006
  • A Working Group has met at least monthly for the past two years to develop and refine this concept
  • Funding was received from the National Association of County and City Health Officials (NACCHO) and the Robert Wood Johnson Foundation (RWJ) to allow the Working Group to bring in expert consultants to assist with the planning process
  • The Working Group conducted 22 hearings across the state in early 2007 to discuss findings and generate recommendations and as a result expanded its membership to include additional local health representation
  • Representatives from the Working Group testified in 2007 before the legislative Joint Committee on Public Health at their Hearing on regionalization and local public health
  • Massachusetts Department of Public Health (MDPH) Commissioner John Auerbach has identified regionalization and support for local health as key priorities for his administration
Next Steps:
  1. Progress Report
  2. Steering Committee meeting on January 31, 2008
  3. Statewide meeting on February 29, 2008
 
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