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The 191st General Court of the Commonwealth of Massachusetts

AN ACT RELATIVE TO STRENGTHENING THE LOCAL AND REGIONAL PUBLIC HEALTH SYSTEM.

Whereas, The deferred operation of this act would tend to defeat its purpose, which is to strengthen forthwith the local and regional public health system, 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 27C the following section:-

Section 27D.  (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, shall establish a state action for public health excellence program to encourage boards of health to adopt practices that will improve the efficiency and effectiveness of the delivery of local public health services. Local public health services shall include, but not be limited to, communicable disease control, chronic disease and injury prevention, environmental public health, maternal, child and family health and access to and linkage with clinical care. The program shall promote and provide resources for boards of health that shall include, but not be limited to:

(i)  elevating performance standards to improve the municipal and regional public health system;

    (ii)  increasing cross-jurisdictional sharing of public health services to strengthen the service delivery capabilities of the municipal and regional public health system;

   (iii)  improving planning and system accountability of the municipal and regional public health system, including how data is reported and analyzed;

    (iv)  establishing workforce standards, including, but not limited to, education and training standards for municipal and regional public health officials and staff; and

(v)  expanding access to professional development.

(c)  Subject to appropriation, the department shall provide comprehensive core public health educational and training opportunities to municipal and regional public health officials and staff. The department shall provide the training not less than 4 times per year and shall be held in diverse geographic locations. The department shall provide such training opportunities free of charge.

(d)  Subject to appropriation, the department shall establish a state action for public health excellence grant program. Boards of health and regional health districts may apply for funding and technical assistance to support:

(i)  the implementation of regional, inter-municipal collaboration and to increase efficiency and effectiveness in the delivery of local public health services; or

    (ii)  planning and capacity building to facilitate regional collaboration or other strategies to implement regional collaboration.

Funds shall be awarded on a competitive basis and shall supplement and not replace existing state, local, private or federal funding to boards of health and regional health districts. To be eligible to receive funds, an applicant shall submit an application in a manner determined by the department; provided, however, that the application shall include, but not be limited to: (i) a description of how the applicant will increase the efficiency and effectiveness in the delivery of public health services across 2 or more municipalities if awarded the grant; (ii) certification that, at the time of the application, the applicant meets workforce standards as determined by the department; (iii) certification that the applicant shall submit written documentation on the implementation of systems to increase efficiency in providing local public health services, including data, to the department at the end of the grant year in a manner to be prescribed by the department; and (iv) a plan for the long-term sustainability of strengthening local public health services. The department may offer grantees an option to renew at the end of each grant year.

(e)  The department shall adopt rules, regulations or guidelines for the administration and enforcement of this section including, but not limited to, establishing applicant selection criteria, funding priorities, application forms and procedures, grant distribution and other requirements; provided, however, that not less than 33 per cent of the grants awarded shall go to cities and towns with a median household income below the average of the commonwealth.

(f)  Biennially, not later than March 1 of each year ending in an even number, the department shall submit a report detailing the program’s impact, including, but not limited to: (i) the number of board of health and regional health district officials and staff that meet workforce standards; (ii) the number of board of health and regional health district officials and staff that attended educational and training opportunities; (iii) the number of boards of health and regional health districts that are compliant with data reporting requirements; and (iv) the number of municipalities participating in regional public health collaborations. The report shall be provided to the clerks of the house of representatives and the senate, the house and senate committees on ways and means and the joint committee on public health.

SECTION 2.  (a) The department of public health shall, in consultation with the special commission on local and regional public health, develop a set of minimum standards for foundational public health services for the commonwealth. For the purposes of this section, “foundational public health services” shall include, but not be limited to, local public health services as described in subsection (a) of section 27D of chapter 111 of the General Laws and workforce standards that are necessary to protect the community’s health and achieve equitable health outcomes. The department of public health and special commission on local and regional public health shall consider recommendations from the National Association of County and City Health Officials, the Robert Wood Johnson Foundation, the Public Health Leadership Forum and other relevant experts.

SECTION 3.  (a) Not more than 1 year from the effective date of this act and before the adoption of any rule, regulation or guideline for the administration of the state action for public health excellence program, the department of public health shall hold not less than 4 public hearings in diverse geographic locations for the purpose of identifying way to improve the efficiency and effectiveness of the delivery of local public health services, in alignment with the recommendations of the special commission on local and regional public health established in chapter 3 of the resolves of 2016.

(b)  No later than March 1, 2022, the department shall submit a report to the clerks of the house of representatives and the senate, the house and senate committee on ways and means and the joint committee on public health. The report shall include an analysis of needs, opportunities, challenges, timeline and cost analysis for the implementation of the foundational public health services.

SECTION 4.  The special commission on local and regional public health established in chapter 3 of the resolves of 2016 is hereby revived and continued.

Approved, April 29, 2020.