HOUSE DOCKET, NO. 5306        FILED ON: 9/30/2020

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 5045

The Commonwealth of Massachusetts

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PRESENTED BY:

Hannah Kane and Denise C. Garlick

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to accelerating improvements to the local and regional public health system to address disparities in the delivery of public health services.

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PETITION OF:

HOUSE DOCKET, NO. 5306        FILED ON: 9/30/2020

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 5045

The Commonwealth of Massachusetts

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In the One Hundred and Ninety-First General Court
(2019-2020)

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An Act relative to accelerating improvements to the local and regional public health system to address disparities in the delivery of public health services.

Whereas, The deferred operation of this act would tend to defeat its purpose, which is to protect forthwith the health and wellness of the residents of the Commonwealth, therefore it is hereby declared to be an emergency law, necessary for the immediate preservation of the public health.
 

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 111 of the General Laws is hereby amended by inserting after section 27D, added by section 1 of chapter 72 of the acts of 2020, the following section:-

Section 27E. (a) For the purposes of this section, the term “board of health” shall include any body politic or political subdivision of the commonwealth that acts as a board of health, public health commission or a health department for a municipality; provided however, that “board of health” shall include, but not be limited to, municipal boards of health, regional health districts established under section 27B and boards of health that share services pursuant to section 4A of chapter 40.

(b) The department, in consultation with municipalities and other stakeholders, including, but not limited to, members of the Special Commission on Local and Regional and Public Health, shall establish a uniform set of minimum local public health performance standards to ensure that every resident of the commonwealth has access to a core set of public health protections including, but not limited to, communicable disease control, public health nursing services, food and water protection, chronic disease and injury prevention, environmental public health, maternal, child and family health and access to and linkage with clinical care. The standards shall take into account national public health standards.

(c) The local public health performance standards shall include: (1) workforce education, training, and credentialing standards; (2) standards for contributing data to a unified standard public health reporting system; and (3) minimum performance standards for inspections, communicable disease investigation and reporting, permitting and other local public health responsibilities as required under laws and regulations.

(d)  Boards of health shall meet these standards individually or through cross-jurisdictional sharing of public health services in the form of comprehensive public health districts, formal shared services, and other arrangements for sharing public health services. Boards of health shall demonstrate compliance with the standards in an annual report to the department. Data demonstrating compliance shall be submitted in a form prescribed by the department. The report shall not require data that is otherwise reported to the department under subsection (e).

(e) The department of public health and the department of environmental protection shall create a unified standard public health reporting system. The data collected and reported shall include measures of standard responsibilities of boards of health, including inspections, code enforcement, communicable disease management, and local regulations. The data and an analysis of the data shall be available on the department of public health’s website in a form that allows the public to conduct further data analysis.

(f) The department shall issue a report every 2 years on the status of the local public health system and its ability to meet the standards under this section. The report shall be submitted to the house and senate committees on ways and means and joint committee on public health. The report shall be posted on the department’s website.

(g) (1) Subject to appropriation or availability of other funding, to supplement local funding, dedicated state funding shall be provided to local boards of health which meet the standards established in this section, using a formula based on population, relative equalized valuations, level of cross-jurisdictional sharing and sociodemographic data. The department shall determine for each fiscal year the amount of funds sufficient to meet the requirements of this clause.

(2) Subject to appropriation or availability of other funding, the department shall make funds available to support boards of health to meet the standards established in this section. To receive such funds, boards of health shall demonstrate that they meet benchmarks established by the department and demonstrate progress toward meeting the standards established in this section.

(3) Subject to appropriation or availability of other funding, the department of public health and the department of environmental protection shall offer sufficient training and technical assistance for local public health staff to support them in obtaining credentials and capabilities required under the standards. The department of public health may enter into subcontracts with regional planning agencies, statewide organizations, or other entities to provide training and technical assistance.  The department of public health shall determine for each fiscal year the amount of funds sufficient to meet the requirements of this clause.

(h) The department shall establish a statewide sustainable local public health budget, determined as the sum of the required local supplemental funding under clauses (1) to (3), inclusive, of subsection (g) for every town and city in the commonwealth. The department shall report the estimated statewide sustainable local public health budget to the secretary of administration and finance for the upcoming fiscal year on the day assigned for submission of the budget by the governor to the general court pursuant to section 7H of chapter 29 and shall publish it on the website of the department.

(i) The standards required by this section shall not be enforceable if sufficient funds, as determined by the department under clause (1) of subsection (g), are not made available to local boards of health and the department. If sufficient funds under clause (1) of subsection (g) are not made available to boards of health, funds made available under clauses)(2) and (3) of subsection (g) shall be expended for the purposes of those clauses.

(j) Subject to appropriation or availability of other funding, the department of public health shall provide a comprehensive online permitting and inspection system available to all boards of health.

SECTION 2. The initial standards under subsections (b) and (c) of section 27E of chapter 111 of the General Laws shall be consistent with the recommendations of the report of the Special Commission on Local and Regional and Public Health approved in June 2019. The standards shall become effective no later than 60 days following the passage of this act. The standards may be amended by regulation no less than 1 year following approval of the initial standards.

SECTION 3. Funds provided under clause (2) of subsection (g) of section 27E of the General Laws shall be made available no longer than 3 years after the enactment of this act.