AN ACT RELATIVE TO PUBLIC HEALTH REGIONALIZATION.
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 striking out sections 27A to 27C, inclusive, as appearing in the 2006 Official Edition, and inserting in place thereof the following 3 sections:-
Section 27A. Two or more municipalities may, by vote of each, form a district for the purpose of employing therein a health officer and necessary assistants and clerks, all of whom shall be appointed and may be removed by a joint committee composed of either the boards of health of the municipalities or 1 or more representatives from the board of health of each municipality. Persons so employed shall perform such duties and receive such compensation as the joint committee shall determine and, in so far as their duties in a given municipality are concerned, shall be the employees of and responsible to the regularly constituted board of health of such municipality. The department, in consultation with the department of environmental protection, may adopt regulations to set minimum qualifications for health officer pursuant to this section. The joint committee shall annually elect a chairman and a secretary and shall determine the relative amount of service to be performed in each municipality of the district by employees of the district. The treasurer of 1 of the municipalities of the district, designated by the joint committee, or such other treasurer designated by the joint committee, shall be treasurer of the district and shall give to the district a bond with a surety company authorized to transact business in the commonwealth as surety, for the faithful performance of his duties as treasurer of the district, in such sum and upon such conditions as the joint committee may require. The joint committee, annually in the month of December, shall estimate the amount of money required to pay the costs and expenses of the district for the following year, shall fix and determine the proportion of such costs and expenses to be paid by the respective municipalities thereof during the year and shall certify the amount so determined for each such municipality to its assessors who shall include such amount in the tax levy of such year. Upon order of the board of health of each municipality, the municipal treasurer thereof shall, from time to time and subject to section 52 of chapter 41, pay to the district treasurer such sums not exceeding the amount certified by the joint committee as the municipality’s share of the costs and expenses of the district. The district treasurer shall disburse the money so received, upon warrants approved by the health officer. A member municipality of a regional health district formed pursuant to this section may withdraw by majority vote of its legislative body and the vote to withdraw shall become effective on the last day of the next fiscal year. This section shall not apply in the county of Barnstable.
Nothing in this section shall be construed to prohibit a board of health that is not part of a regional health district from appointing as its health agent, a health agent employed by another municipality pursuant to section 30, and setting the salary and terms of employment thereof if such health agent has received written approval from the original appointing authority and the health agent is either: (a) a physician, having graduated from an accredited approved school of medicine and registered, or eligible for registration, to practice medicine in the commonwealth, with 1 year of full-time graduate public health academic training or 2 years of full-time experience in public health; or (b) a lay person with professional academic training equivalent to a bachelor’s degree and with 5 years of administrative experience and supervision of generalized public health programs or a registered sanitarian, certified pursuant to section 87 OO of chapter 112. If a lay health officer is employed, a registered physician shall also be employed to perform such medical functions as are required.
For 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.
Section 27B. Two or more municipalities may, by vote of their respective boards of health and, in a city having a Plan E charter by the affirmative vote of a majority of all members of the city council, in other cities by vote of the city council and approval of the mayor, and by vote of a town at a regular annual town meeting, form a regional health district which shall consist of a regional board of health, a director of health and staff thereof. Towns and cities may, in a like manner, join a regional health district previously formed with the approval of the regional board of health of such district. The regional health district may have all the powers and may perform all the duties conferred upon, or exercised by, the boards of health and health departments of the constituent municipalities under any law or ordinance pertaining thereto, except in so far as the regional health district may, by majority vote, delegate certain powers and duties to the constituent municipalities. Notwithstanding the foregoing, a constituent municipality shall retain its legal authority under chapter 111 and section 6 of Article 2 of the Amendments to the Massachusetts Constitution, unless and until a municipality votes, by vote of its board of health and, in a city having a Plan E charter by the affirmative vote of a majority of all members of the city council, and in other cities by vote of the city council and approval of the mayor, and by vote of a town at a regular annual town meeting, to delegate part or all of its legal authority to the regional board of health.
The regional board of health, hereinafter referred to as the board, shall be comprised of at least 1 representative from each constituent municipality. Unless the board votes otherwise, each constituent municipality having a population greater than 10,000 shall have 1 additional representative to the board for every population unit of 10,000 or major fraction thereof beyond the first 10,000. In no instance shall there be more than 5 representatives from a single municipality on a board. Towns shall, at a town meeting, select or change the method of selecting their representative or representatives by any of the following methods: (a) by appointment of the board of health; (b) by appointment of the selectmen; (c) by vote at the annual town meeting; or (d) by any other method decided at the annual town meeting. In cities, such representatives shall be appointed by the mayor with the approval of the city council, or in cities having Plan E charters by the city manager, unless a definite mode of appointment is otherwise provided by the city charter. Each representative shall serve for a period of 3 years, except that at its initial organization the board shall decide the term of years for the first representatives who shall be elected or appointed to the board, so that thereafter approximately one-third of the representatives will be elected or appointed each year. Such representatives shall serve without compensation, but shall receive their necessary traveling expenses from the board while in the performance of their official duties. Representatives to the board may be re-elected or reappointed for a maximum of 2 terms. The board shall meet annually and at such other times as it shall determine by its rules or when requested by the chairman of the board or the director of health.
Each board may make and adopt reasonable rules and regulations for the promotion of general health within the district not in conflict with law, ordinance, by-law or any fire, health or safety regulation. The powers of each district shall include, but not be limited to, the power to: (1) sue and be sued; (2) make and execute contracts and other instruments necessary or convenient to the exercise of the powers of the health district; (3) make and from time to time amend and repeal rules and regulations relative to the operation of the district; (4) receive and expend funds; (5) apply for and receive grants from the commonwealth, the federal government and from other grantors, if the purpose of the grant is to improve public health; and (6) have such other powers as are necessary to properly carry out its powers as an independent entity of government.
Any constituent municipality that has been a member of the district for at least 3 years may withdraw from the district, by vote of its board of health and its respective legislative bodies passed prior to July first in any year, and the withdrawal shall be effective January first of the following year. In the event of the withdrawal of a town or city from the district, or in the event of dissolution of any district, the employees thereof, if originally employed by a municipality, shall automatically become employees in the same position they held in such municipality’s board of health.
The board shall select a treasurer, who may be the treasurer of 1 of the constituent municipalities or such other treasurer as designated by the board, to act as treasurer for the district. For the faithful performance of his duties, the treasurer shall give bond, with a surety company authorized to transact business in the commonwealth, in such sums and upon such conditions as the board may require. The board shall, annually, in the month of December: (a) estimate the amount of money required to pay the cost and expense of the district for the following year; (b) fix and determine by a majority vote the proportion of such costs and expenses to be paid by the individual municipalities thereof during such year; and (c) certify the amount so determined for each municipality to the assessors thereof, who shall include such in the tax levies of each year, and each municipality shall appropriate such sum for the district. In apportioning the costs, the board, by a majority vote, may use any of the following formulae as a basis for its apportionment: (a) valuation, according to the latest state valuation, establishing the basis of apportionment of state and county taxes; (b) population, as determined by the most recent estimate by the state secretary, exclusive of universities and federal, state and county institutions; (c) a combined formula of valuation according to the latest state valuation and population as determined by the most recent estimate by the state secretary, exclusive of universities and federal, state and county institutions; or (d) any other method decided by majority vote of the board. Upon order of the board, the treasurer of each constituent municipality thereof shall, from time to time, subject to section 52 of chapter 41, pay to the treasurer of the district the amount certified by the board as the municipality's share of the cost and expenses of the district. The treasurer of the district shall disburse the money so received upon warrant approved by the director of health and signed by the chairman or vice-chairman of the board. The accounts of each district shall be audited annually by the bureau of accounts of the department of corporations and taxation, under sections 35, 40 and 41 of chapter 44.
The board shall appoint, and may reappoint, for a term of 3 years, a director of health, hereinafter referred to as the director. The board may remove the director for cause after proper notice and a public hearing. The director shall serve as secretary of the board, but shall have no vote. He shall be the executive and administrative head of the district and, may, with the approval of the board, designate 1 or more deputies and may appoint and employ, with like approval, such assistants as may be provided for in the budget. The director shall prepare and present annually to the board a report and a budget for its approval, together with such recommendations as he deems proper. The department of public health, in consultation with the department of environmental protection shall adopt regulations to set minimum qualifications for directors of health and other employees hired pursuant to this section.
The board shall adopt reasonable rules and regulations, for which notice and public hearing shall be given in the same manner and extent as required by section 37 of chapter 30 and section 2 of chapter 30A. The board shall also: (a) take evidence in appeals; (b) consider plans and appointments required by law; (c) hold hearings; and (d) discharge such other duties required by law, but the board shall have no administrative or executive functions. The board may delegate the holding of hearings to the director or his deputies. The board may elect an executive committee consisting of its chairman, vice-chairman, secretary and such other members as its rules may determine. The executive committee shall have the authority to act for the board when the board is not in session.
All full-time and part-time incumbents of any office or position brought under the district at the time of its formation shall be transferred thereto without loss of civil service, retirement or other rights. Any transferred employee’s compensation shall be fixed by the board at not less than the amount received by the employee during the fiscal year preceding the date such employee was transferred to the district. Any person hired pursuant to this section shall be hired in accordance with the merit system, personnel policies and compensation plans approved by the board. Any employee whose employment was governed by chapter 31 shall be transferred to the district with duties comparable to those previously performed by him and shall have all rights and privileges accruing to him from his previous position. Any employee whose employment was not governed by said chapter 31 shall be transferred to the district in a comparable position. The employee shall have all rights and privileges accruing to him from his previous position. If a new position is governed by said chapter 31 such employee shall be classified in the competitive civil service without examination. All positions and offices of the district, including the director, but excluding representatives to the board, shall be subject to the provisions of chapter 32. Ninety days after the organizational meeting of the board, all district positions and offices, except the director and the representatives to the board, not subject to chapter 31 at the time of the formation of the regional board of health, shall be placed within the civil service in the manner provided by said chapter 31 and the rules and regulations promulgated thereunder, and all positions and offices subsequently established by the board shall be subject to said chapter 31 and the rules and regulations thereof, unless the board by a majority vote within 90 days after its organizational meeting votes not to extend said chapter 31 to any or all of such eligible positions and offices. At any time after such a vote to exclude, the board may, by a majority vote, bring within said chapter 31 any or all positions and offices, in the manner set forth therein, except the director and the representatives to the board, which were excluded but which are still subject to the jurisdiction of the board. The wages and salaries of all offices and positions, including those subject to chapter 31, shall be determined by the board. The department in consultation with the department of environmental protection, shall establish by regulation minimum performance standards, including standards for inspection and enforcement, for basic programs of public health administration, personal health, laboratory services, health resources and other preventive health programs not inconsistent with law, as it finds necessary or desirable for the protection of public health.
For purposes of this section, the words “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.
Section 27C. (1) Each regional health district established under section 27B shall be entitled to reimbursement from the commonwealth, subject to appropriation, for expenditures incurred by it for initial capital outlays, including the acquisition, construction, improvement or renovation of any buildings or premises for the use of the district and any original furnishings and equipment therefor, but excluding the costs of supplies, salaries and other expenses for the ordinary maintenance and operation of the district. The department shall establish, by regulation, a formula for allocating state funds for initial capital outlays to each regional health district. In order to qualify for such reimbursement, a regional board of health shall, before incurring any expenses reimbursable under this section, submit to the commissioner an itemized statement of all proposed expenditures for such purposes. The commissioner shall examine such statement and shall notify such board to what extent, in his opinion, the proposed expenditures are reasonably necessary for the purposes of the regional health district and reimbursable hereunder, and the probable amount of reimbursement therefor. Within 3 months after the date of final payment for such capital outlays the board shall submit to the commissioner a certified statement of its actual expenditures for such purposes. If satisfied that the expenditures so certified are reimbursable and not unreasonable or excessive, the commissioner shall certify to the comptroller and the treasurer shall forthwith pay to such regional health district, from any amounts appropriated therefor, the amount of such approved reimbursement.
(2) A formula shall be established, subject to appropriation, for allocating state funds for operating expenses to each regional health district. This formula shall include the requirement of municipal matching funds on a basis to be determined from the annual tax receipts of each participating city or town. Districts receiving state funds shall meet the performance standards and personnel qualifications adopted by the department of public health pursuant to section 27B. Such regional health districts may use additional funds, which they may secure from other sources. In the event that a city or town fails to appropriate its required matching funds from the annual tax receipts, such city or town shall be removed from the regional health district.
Approved January 15, 2009