Lawmakers, advocates hit Baker’s opt-in approach to public health
Say it would perpetuate patchwork of municipal services
By 
A BILL OVERHAULING the state’s fractured public health system appears to have become a casualty of the last-minute legislative rush to pass bills in the final days of the legislative session.
Gov. Charlie Baker returned the bill to the Legislature with an amendment on Monday night. By Tuesday, public health advocates and lawmakers had come out in opposition to his amendment – which procedurally is likely to doom the bill.
Typically, the Democratic-led Legislature is in a strong position to overrule the governor, since Democrats hold veto-proof majorities in the House and the Senate and can easily muster the two-thirds vote needed to override a veto. But an override requires a roll call vote, which must be taken during formal legislative sessions. By passing a flurry of bills in the final days before the session ended July 31, lawmakers put themselves in a position where they would no longer be in session to conduct veto overrides.
If the governor amends a bill, lawmakers can pass his amendment in an informal session, if no legislator objects. If they try to pass their original language again, Baker could simply veto it, leaving the Legislature with no recourse.
So far, those consequences have included a failure to get free phone calls for prison inmates signed into law, a provision Baker does not oppose but held up in a bid to get elements of his “dangerousness bill” passed. Lawmakers refused to pass the dangerousness provisions, so the phone calls remain in limbo.
Now, the public health overhaul may be another lost opportunity. The bill would have set minimum standards that local public health departments would have to abide by, in areas from inspections to disease reporting. It would have provided state funding for municipal public health departments to help them meet these standards.
Baker sought to turn requirements into a local option rather than a mandate, so communities could opt into the new standards and funding. In his amendment letter, Baker worried that lawmakers would over the long term fail to provide adequate funding, turning the standards into an unfunded mandate on communities. He also wanted to add a provision requiring municipalities to maintain local spending on public health in order to get the additional state money.
But legislators and public health advocates on Tuesday said Baker’s amendment would weaken the bill and make the current patchwork of local health departments worse.
The bill’s primary sponsors – Rep. Denise Garlick, a Needham Democrat; Rep. Hannah Kane, a Shrewsbury Republican; and Sen. Jo Comerford, a Northampton Democrat – issued a joint statement saying they are “deeply disappointed” in Baker’s amendment. The lawmakers said the bill has been crafted over two years in consultation with Baker’s Department of Public Health and local public health leaders and experts. They said the premise of the bill is that all residents deserve equal public health protections, regardless of where they live.
“The bill recognizes – for the first time – that the state has a role in setting uniform public health standards, incentivizing shared services, building a comprehensive data and reporting framework, supporting the training and credentialing of public health workers, and in funding local public health,” they wrote.
They said the governor’s amendment would not achieve this goal of ensuring every community has robust public health services. “The governor’s amendment to allow public health protections to be provided by municipalities on an opt-in basis will lead to even more of a patchwork infrastructure and perpetuates the very problem the Legislature unanimously voted to fix,” they wrote.
Melrose Mayor Paul Brodeur, who is vice-chair of the Metropolitan Mayors Coalition, said advocates are disappointed “and will work with the Legislature to ensure that we do not wait another year before the provisions of SAPHE 2.0 that matter most become law,” referring to the bill’s title, Statewide Accelerated Public Health for Every Community. Potentially, lawmakers could develop a compromise bill that Baker would be willing to sign, but that would have to be negotiated and passed in informal sessions.