BOSTON — Nearly a year after the state poured millions of dollars into modernizing the state’s public health system, leaders in the field — including those who oversee collaboration between some 14 communities in Hampshire County — are lauding the advances they’ve been able to make with the state support.
“For decades small rural towns, especially in western Massachusetts and in our region have operated with boards of health that were either volunteer based or provided a small stipend …,” said Merridith O’Leary, commissioner of Northampton’s Department of Health & Human Services told a panel of lawmakers led by Sen. Jo Comerford on Tuesday. “With strong support from my mayor (Gina-Louise Sciarra) and the DHHS leadership team we have worked to make sure the stability and equity we maintain in Northampton extends to surrounding Hampshire County towns we serve … smaller towns could simply not provide these services on their own.”
This work has been accomplished thanks to the new program called SAPHE 2.0, or the Statewide Accelerated Public Health for Every Community, that was wrapped inside an expansive $4 billion economic development bond bill signed into law last November by Gov. Maura Healey. The overall goal of SAPHE 2.0, filed by Comerford and state Rep. Hannah Kane, aims to modernize public health in the commonwealth.
SAPHE 2.0 creates minimum public health standards for every Massachusetts community, — which previously did not exist — dedicates state funding to support local boards of health and health departments, ensures workers hold the necessary credentials, provides training and creates a uniform data collection and reporting system to be used across cities and towns.
“This is such a game-changer and so transformative,” Comerford said about SAPHE 2.0 in an interview with the Gazette. “We thought it was really important that we make sure our colleagues understand what is happening because we went from a state that had 351 completely different ways of approaching public health and resourcing public health to a state with public health standards, training credentials and plans, data collection and a commitment on the part of the state to fund some of this.”
Tuesday’s presentation welcomed Sam Wong, the state director of the Office of Local and Regional Health, who emphasized the importance of shared health services.
“What makes Massachusetts exceedingly unique is that we have one of the most decentralized (public health) systems,” he said.
He explained Massachusetts’ public health system is considered an outlier. There are more local public health jurisdictions than any other state — 351 one for each city and town — with sharing of services among municipalities historically limited.
SAPHE 2.0 aims to address that challenge and encourage more collaboration across municipal lines. More than 90% of Massachusetts municipalities are leveraging Public Health Excellence (PHE) grants, totaling $26.2 million to 322 municipalities, to meet established performance standards, expand capacity and deliver more equitable local public health services.
SAPHE 2.0’s birth is part of a four-year process dating back to the COVID-19 pandemic. In response to the pandemic, the state created SAPHE 1.0 in April 2020 to help preserve public health. A year later, the American Rescue Plan Act (ARPA) was signed into law and designated $200 million in funds, surging the push for SAPHE 2.0. Finally, the bill created a pathway for SAPHE 2.0 to provide equitable public health services across the state.
A prime example of a shared services team is the Northampton-based Hampshire Public Health Shared Services Collaborative (HPHSSC), which O’Leary oversees out of DHHS. O’Leary shared how the collaborative boosts resources for rural towns in Hampshire County, while her counterparts from central Massachusetts and the Greater Boston area also lauded the program.
Formed in 2022, the HPHSSC consists of 14 Hampshire County communities that pool resources, functions, and expertise. These towns include Northampton, Amherst, Easthampton, Hadley, Granby, many hilltowns and more.
Some of these shared services include blood pressure clinics, vaccine information, Narcan distribution and a variety of health education programs. One education program includes a space at the University of Massachusetts, Amherst which offers training services to local public health officials.
“At a time when public health across the nation faces chronic underfunding, erosion in trust and growing division, this program (SAPHE 2.0) instead brought resilience, equity and unity to the 14 very different communities in western Massachusetts,” said O’Leary.
Ahead of future budgeting seasons, Comerford hopes the presentation would show her colleagues the importance of public health funding, a field whose work often goes unnoticed. Next fiscal year, $34 million in federal funding will expire for Massachusetts public health investments.
“It’s really the precursor to the conversation I know we’re going to have to have in fiscal year 27 budget (planning),” she said. “DPH (Department of Public Health) has also pushed through a lot of work. The amount of work was so significant and the gains made were so significant that Rep. Kane and I thought it was important that we update our colleagues so that they could understand the truly transformational efforts.”
Comerford said there is already talk of running a SAPHE 3.0, to keep pushing the needle forward toward tackling public health goals.
“I’m really proud of the leadership of western Massachusetts in really ensuring the true fulfillment of this moment because there is no end of positive return for us in the commonwealth and we just got started,” said Comerford.