Lawrence and Methuen make amends

On verge of a breakup, agree to keep public health alliance alive

Lawrence and Methuen have, for now, salvaged a partnership to provide public health services to their residents after a rift nearly cost both cities almost $2 million in state grant money.

Just a few weeks ago, Lawrence and Methuen were on the cusp of a messy breakup after Methuen officials complained Lawrence had not met standards needed to maintain a functional collaboration. To repair the relationship, Lawrence officials have agreed to fill some key public health positions and reform its public health service.

Without a working partnership, Lawrence and Methuen would have both missed out on renewing a Public Health Excellence grant worth $1.75 million over the next three years. The state Department of Public Health is in the midst of renewing those grants, which are available to municipalities that participate in shared services agreements.

A spokesperson for the department confirmed Methuen and Lawrence are eligible to receive the grant.

The disagreements and differences between the two cities — Methuen is smaller but wealthier; Lawrence is larger and poorer — are stark examples of the challenges Massachusetts faces in its effort to regionalize public health delivery in the state.

“Change isn’t easy, and these agreements take time, as evidenced in this relationship,” said state Senator Joanne Comerford, a Democrat from Northampton, who is sponsoring a bill currently in the House Ways and Means Committee that would require municipal health departments to meet state performance standards.

Public health, which includes the work of ensuring restaurants, swimming pools, and homes are safe, is largely handled in Massachusetts by 351 local health departments. In small communities, or those that aren’t devoting money to public health services, those departments can be

woefully understaffed and underfunded. The need to regionalize public health became apparent during the COVID-19 pandemic, officials said, when some smaller departments were overwhelmed by the need to provide contact tracing, health guidance, and disease testing at a massive scale.

For the past three years, the state has encouraged Massachusetts’ 351 local health departments to pool resources, ideally providing better services than many could individually.

“The real story here is the story of the transformational change we can achieve across the state if we focus on this model,” Carlene Pavlos, executive director of the Massachusetts Public Health Association, said in an interview in March.

The Lawrence and Methuen partnership, though, has been beset by problems, due in part to a huge disparity in the cities’ public health spending. Lawrence, a city of nearly 90,000, spends less than $2 per resident on public health per year, compared with $21.62 per resident in Methuen, public health officials in Lawrence and Methuen said last month. Lawrence officials disputed that number, saying it doesn’t include funding for inspections, though they didn’t provide a more accurate number.

In a scathing review of Lawrence’s health services during a City Council meeting last month, Ethan Mascoop, the shared services coordinator for Lawrence and Methuen, described a city that either is not keeping up with required inspections or is doing them incorrectly. The city has also mismanaged grant money meant to bolster public health services, he said.

In a previous interview, Lawrence officials acknowledged deficiencies in its health services but said they were working on improvements.

Mascoop has himself become a focal point of the dispute, with Lawrence officials saying in February they would not work with him, which appeared to end the shared services agreement. Methuen responded by exploring the possibility of partnering with Haverhill, instead.

Methuen officials did not respond to requests for comment this week.

The level of discord between Lawrence and Methuen is unique among the 320 municipalities participating in 51 public health shared services agreements statewide, Pavlos said. There are challenges, though, she said, harmonizing public health services among communities that differ in size, capacity, and priorities.

“Local public health is expected to keep up with those priorities at the same time as they’re building this critical infrastructure,” she said. “It is hard work, no question about it.”

Lawrence officials recognize the need to put more money into public health, said Joel Gorn, chair of the city’s board of health.

Gorn intends to push the city to ensure that happens, including by hiring a new director of Inspectional Services, an office that also oversees public health. Eventually, he said, the city would hire a public health director to give public health independence from Inspectional Services. That would require the city council’s approval, officials said.

“I do have a vested interest in the city and making sure this public health agreement stays intact,” he said.