Senate Passes Legislation to Strengthen Local Public-health Services

BOSTON — The Massachusetts Senate passed legislation on Friday to address disparities in local and regional public-health systems. The bill, also known as the Statewide Accelerated Public Health for Every Community (SAPHE) Act 2.0, would encourage wider technical coordination among Massachusetts’ 351 separate boards of health, establish common standards among these boards, and ensure that these boards of health are funded equitably.

This legislation implements the unanimous recommendations of the Special Commission on Local and Regional Public Health and was a key recommendation of the July 2022 report of the Joint Committee on COVID-19 and Emergency Preparedness and Management. This bill also follows the historic $200.1 million that the Legislature included in the December 2021 American Rescue Plan Act bill to support the state’s local and regional public-health infrastructure.

“With the passage of this legislation, a person’s zip code will no longer determine the public-health protections that they are afforded, and local public-health officials will have the resources they need to do their jobs,” said state Sen. Jo Comerford, Senate chair of the Joint Committee on COVID-19 and Emergency Preparedness and Management and also of the Joint Committee on Public Health. “I am deeply grateful to Representatives Hannah Kane and Denise Garlick, Department of Public Health and Health and Human Services officials, the Massachusetts Public Health Association, and all who advocated for a better day for public health. That day has come.”

Currently, Massachusetts does not have a public-health framework to guide local boards of health. SAPHE 2.0 directs the Department of Public Health (DPH), in consultation with municipalities and other stakeholders, to develop a set of standards for local public-health systems in accordance with national standards and the recommendations of the Special Commission on Local and Regional Public Health. Standards will be set for communicable-disease control, public-health nursing services, food and water protection, chronic-disease and injury prevention, environmental public health, access to clinical care, and maternal, child, and family health.

The bill also directs DPH and the Department of Environmental Protection to provide core public-health educational and training opportunities and technical assistance to municipal and regional public-health officials. This will help to prevent a situation from arising in which a board is unable to access health expertise from a credentialed member of the public-health workforce.

To help ensure a sustainable state funding mechanism that addresses regional inequities and differing qualities of public-health preparedness throughout the state, this legislation directs DPH to estimate annually, before the governor files a budget, the funds needed for local and regional health boards to meet the minimum standards set forth in the bill.

By enhancing and incentivizing cross-jurisdictional sharing, the bill will result in cost savings and more effective service delivery. The bill creates a uniform reporting system which includes metrics for inspections, code enforcement, communicable-disease management, and local regulations, and will make this data available (excluding personally identifying information).

Having passed both Senate and the House of Representatives, this legislation awaits Gov. Charlie Baker’s consideration.