The relationship between the state of Massachusetts and its cities and towns is a complicated one. Sometimes, as with liquor licenses, the state is in control, deciding how many licenses should be issued in each community. 

But other times cities and towns are the ones in charge. Regarding public health, for example, Massachusetts has one of the most decentralized systems in the country, with each town or city responsible for its own public health activities, which run the gamut from food safety to disease investigation to housing, tobacco, public health emergencies, and the health and safety of children at summer camps, pools, and other locations.

“That has resulted in a system in which Massachusetts, unlike pretty much every other state, neither has performance standards, workforce standards, or stable funding for local public health. So each of our towns has to decide what kind of preventions and protections do they want to actually pay for out of their tax revenue,” said Phoebe Walker, director of community services for the Franklin Regional Council of Governments.

Walker and Ruth Mori, the president of the Massachusetts Association of Public Health Nurses, talked about public health at the local level on The Codcast with hosts Paul Hattis of the Lown Institute and John McDonough of the T.H. Chan School of Public Health at Harvard University.

Walker said there was little awareness of what local public health departments did before the pandemic, but that changed as society became preoccupied with COVID-19. She said it quickly became apparent that local public health departments, with their varied responsibilities and funding levels, were not up to the task of taking on a new and challenging disease.

She said the lack of capacity at the local level forced the state to step in, including spending $161 million to set up a statewide contact tracing effort that has now been dismantled. She said differences in funding from town to town resulted in divergent services from community to community. 

”What we found in the course of this pandemic is those differences are pretty dramatic and  resulted in really uneven results for the residents of Massachusetts,” Walker said. 

Mori said some issues can’t be left to local control if funding levels are inadequate. “This really shouldn’t be a local public health decision if you need a public health nurse or not,” she said.\

Walker said the problems facing local public health were well documented before COVID hit with the development of a Blueprint for Public Health Excellence in 2019. She said the blueprint showed what needed to be done but unfortunately COVID hit before any of those reforms could be implemented.

Now, with the help of $200 million in federal relief funds, the weaknesses in the local public system are starting to be addressed. “Funding, bottom line, is what’s going to make a difference in local public health,” Mori said. 

Walker agrees, but says additional funding will only work if the Statewide Accelerated Public Health for Every Community Act 2.0 passes. The legislation would set in motion standardized training and performance standards for local boards of health along with adequate state funding and data gathering.

BRUCE MOHL 

 

FROM COMMONWEALTH

Billionaires vs. millionaires: Nantucket residents are at odds over how to regulate short-term rentals, with the issue likely to come to a head at town meeting in May. Some see it as a battle between billionaires and millionaires – the uber-rich who can afford a second home on the island without having to rent it out (and don’t want the churn that accompanies rentals) and the rich who need some rental income to make ends meet. Read more.

Note to readers: CommonWealth sorts through the pushback from the Boston Globe and Philip Morris over our story about sponsored content advertising. We could have handled some issues better, but overall the story illustrates the confusion over sponsored content, even among very smart people.  Read more.

Best month ever: Encore reported its best month ever in March, fueled primarily by growth in slots revenue. Read more.

OPINION

Nursing home accountability: Paul Lanzikos, Arelene Germain, Richard T. Moore, and James Lomastro of Dignity Alliance say nursing homes need support – and a lot more accountability. Read more.

 

FROM AROUND THE WEB

MUNICIPAL MATTERS  

Mayor Michelle Wu names James Arthur Jemison II, a veteran housing official who has worked in Massachusetts state government, the federal Department of Housing and Urban Development, the Menino administration and held a key post in the city of Detroit, to be Boston’s new chief of planning. (Boston Globe) 

Cryptocurrency executive Ryan Salame adds a sixth property to his real estate holdings in Lenox. (Berkshire Eagle)

Three members of the Great Barrington Housing Authority Board resign amid unrest on the panel, leaving the agency without a quorum. (Berkshire Eagle)

HEALTH/HEALTH CARE

A Western Mass. EMT profiled by MassLive for a series on front-line workers took her own life. Her family is trying to raise awareness of the mental health needs of first responders. (MassLive)

WASHINGTON/NATIONAL/INTERNATIONAL

TSA stops enforcing a mask mandate for public transportation, including air travel, buses, and subways, after a Florida judge voids the national mandate. (Washington Post) Some US airlines are dropping mask mandates after a federal judge’s ruling in Florida. (NPR)

ELECTIONS

Attorney General Maura Healey has a 45-point lead over rival Sen. Sonia Chang-Diaz in a new UMass Lowell poll of the Democratic primary race for governor. (Politico) 

GOP gubernatorial candidates Geoff Diehl and Chris Doughty continue sparring over debates. (MassLive)

Globe columnist Joan Vennochi wonders why Gov. Charlie Baker, who has earned Donald Trump’s opprobrium by denouncing him, is endorsing hard-right Bristol County Sheriff Thomas Hodgson, the “Sheriff of Trumpachusetts.” 

EDUCATION

Six Quincy school buildings turned 100 in the past decade, and many are still functioning as schools. (Patriot Ledger)

TRANSPORTATION

Masks will no longer be required in Ubers. (MassLive)

ENERGY/ENVIRONMENT

National Grid will unveil a plan today to “decarbonize” its US natural gas pipeline system by 2050. (Boston Globe) The Conservation Law Foundation calls the plan a “false plan.” (WBUR)

Massachusetts residents’ sense of urgency over climate change has dipped slightly, as COVID and war in Ukraine dominate headlines, according to a survey by the MassINC Polling Group. (Boston Globe) 

A bill that passed the state Senate would require homeowner insurers to offer coverage that covers home heating oil spills. (Gloucester Daily Times)

CRIMINAL JUSTICE/COURTS

An off-duty Haverhill police officer is suspended after being charged with OUI. (Eagle-Tribune)

A Hingham man and his father, who is the CFO of a medical device company, pay the federal government $209,000 to resolve allegations of insider trading related to sales of COVID tests. (Patriot Ledger)

A Superior Court judge dismisses a manslaughter case against two foster parents and criticizes Berkshire DA Andrea Harrington’s handling of the case. (Berkshire Eagle)

MEDIA

Joseph Kahn, a Pulitzer Prize-winning foreign correspondent who rose to become managing editor of the New York Times, the paper’s No. 2 position, will lead the paper as its next executive editor when Dean Baquet steps down from that role, a move expected to take place in June. (New York Times) 

The Gannett-owned Patriot Ledger is dropping home delivery and shifting to mail delivery. It is also eliminating its Monday print edition. (Media Nation)