A shot in the arm for health departments

Massachusetts prides itself for being at the forefront of health care, buoyed by its impressive array of nationally recognized medical centers and research facilities.

However, that’s not always the case on Main Street, where the state’s individual municipal health departments have struggled to deliver required services long before the onset of a worldwide pandemic.

And now just five months after Gov. Charlie Baker signed a bill to strengthen local public health infrastructure, lawmakers and advocates who backed that measure warn that it will not secure changes quickly enough without additional legislation to accelerate long overdue improvements.

The state’s 351 cities and towns all have their own health boards and departments that play roles in protecting the public, from enforcing food safety to managing municipal-level emergency preparedness.

But speakers at a press conference Wednesday cautioned that the “decentralized” system fails to set a minimum standard for local health infrastructure and directs no state funding to these departments — creating equity gaps and leaving the commonealth at greater risk in the face of crises like this novel virus.

And as the number of coronavirus cases in Massachusetts continue to rise, some local health officials acknowledge that the challenge of enforcing COVID-19 restrictions has exacerbated structural flaws in the state’s public-health framework that predate this pandemic.

In early August, the governor put the brakes on the state’s economic reopening due to the recent rise in coronavirus cases, lowering outdoor gathering size limits from 100 people to 50, and giving state and local police authority to enforce coronavirus-related orders.

But on the local level, responding to COVID-19 complaints has proved difficult in some cities and towns, straining the capacity and resources of many municipal health departments.

According to Cheryl Sbarra, executive director of the Massachusetts Association of Health Boards, it’s a challenge complicated by the wide variation in available community resources.

A “2.0” bill, filed Wednesday, would dedicate state funding to city and town health departments — something lawmakers said every other state but Massachusetts already does — for planning, technical assistance and operations.

Although some funding has come to health departments specifically to bolster their COVID response, local departments don’t receive annual funding directly from the state.

“We have budgets in some municipalities that are so tiny they don’t even have one full-time staff person, and then we have other health departments that are very well staffed and can take a lot of this added burden,” Sbarra told the State House News service. “But I would guess that all health departments right now are really struggling, because now not only do we have the pandemic, we also have flu season, we have reopening, we have EEE that’s rearing its ugly head.”

This additional legislation would also order the state Department of Public Health to create a single, uniform system for local departments to collect and report health data, incentivize regional cooperation among municipal health offices, and implement some minimum standards of operation in local health departments.

Shrewsbury Republican Rep. Hannah Kane and Needham Democratic Rep. Denise Garlick, authors of the initial legislation, along with Sen. Jo Comerford, a Northampton Democrat, sponsored the new bill.

It seems obvious that given the current challenges alone that this coronavirus presents, it’s imperative the state enacts coordinated policies for municipal health departments to follow, as well as targeted funding to help them serve their communities.

Even in this challenging financial environment, funding in this legislation for these needs would be money well spent.