AMHERST — Several of the region’s public health leaders sat down Monday with the state’s top health official to discuss their work aimed at modernizing the delivery of public health across western Massachusetts.
Health and Human Services Secretary Dr. Kiame Mahaniah and a small cohort of state officials wrapped up a four-leg tour of western Massachusetts with a stop at the University of Amherst Elaine Marieb College of Nursing.
The “Public Health Excellence Tour” was billed as a chance to highlight the Healey-Driscoll administration’s investment in local and rural public health shared-service hubs through Public Health Excellence grants. Prior to UMass, Mahaniah visited the Orange Innovation Center and the Health Center Plaza before going to Gill Town Hall.
Among those who came together were representatives from the Hampshire Public Health Shared Services Collaboration (HPHSSC) and the Franklin-Hampshire Training Hub. Representatives from the organizations explained their work in training local health inspectors and members of boards of health in order to ensure competence and to standardize protocols. They said this work is especially important since often local board members are volunteers and may not have the knowledge to effectively execute their roles.
Leaders of the university’s nursing program also explained their role of being on the front lines of training nurses, and showcased the mannequins and simulators that are used to educate prospective nurses on real-life scenarios on a tour that kicked off Monday’s discussions.
“Being in western Mass, today I saw first-hand the power of our Public Health Excellence grants. Every day, shared-service models are helping to keep communities safe and healthy,” Mahaniah said in a statement after his tour. “I am grateful to all of the public health leaders I met on this trip from Orange to Gill to Amherst serving their communities through services ranging from restaurant and food truck inspections to vaccine clinics and public health nursing.”
State Sen. Jo Comerford, D-Northampton, and a representative from the office of state Rep. Mindy Domb, D-Amherst, highlighted state legislation they have advocated for to infuse state funds into public health needs.
‘SAPHE’
Comerford spoke about how new legislation, the Statewide Accelerated Public Health for Every Community, has standardized public health procedures and protocols for all 351 cities and towns in the state. Prior to SAPHE’s passage over the last two legislative sessions, there was no cohesion or protocols when it came to public health at the local level, and each community followed its own rules, Comerford said.
SAPHE 1.0 passed in April 2020 to help preserve public health during the COVID-19 pandemic. A year later, the American Rescue Plan Act was signed into law and designated $200 million in funds for public health.
That led to SAPHE 2.0, included in a $4 billion economic development bond bill signed into law last November by Gov. Maura Healey. The new law seeks to modernize public health in the commonwealth by implementing standards and credentialing guidelines for municipal health inspectors and those with a position on a board of health. The bill also calls for a uniform data collection and reporting system for all municipalities to use, and dedicates state funding in the form of Public Health Excellence grants to support local boards of health and health departments.
“We went from $0 to money for public health,” said Comerford. “The state realized it had to have skin in the game.”
Going forward, she told those around the table, the state should build on the resources put in place over the past five years.
“There could be a SAPHE 3.0 right?” she said. “Where we go further upstream and we say, OK so we have all this capacity built, we’re collecting all this data, we have all this training, and we have these standards.”
The next step might be focusing on chronic diseases, she said. “Let’s start taking on high cholesterol or heart disease or obesity,” she said.
State money, local investments
UMass’s director of public health, Ann Becker, described the transformation over the past several years after the passing of SAPHE as being a transition “from isolation to infrastructure.”
UMass has become a leader in training nurses thanks to its state-funded mentorship program, which is still getting up to full capacity since launching last November. The Public Health Nurse Consultant Program, a collaboration between the Marieb College of Nursing and the Massachusetts Department of Public Health’s Office of Local and Regional Health, seeks to improve public health across the board by giving public health nurses consistent training and simulations needed to prepare for real-world scenarios.
“We just got the grant a little over a year ago and really only staffed up seven or eight months ago,” said Becker, adding that the mentorship program will prioritize three “buckets” of resources. These buckets are mentorship, technical assistance and a local public health training program.
Other organizations shared how they are using state funds to make a local impact.
Kristen Dearborn, shared services coordinator with Northampton’s office of Health and Human Services, leads the Northampton-based Hampshire Public Health Shared Services Collaborative. She talked about her work in uniting health experts with inspectors and board of health members in communities surrounding Northampton.
Formed in 2022 and backed by $500,000 in state funds, the HPHSSC consists of 14 communities that pool resources, functions and expertise. In addition to Northampton, those communities include Amherst, Chester, Chesterfield, Cummington, Easthampton, Granby, Hadley, Hatfield, Huntington, Middlefield, Plainfield, Southampton and Worthington.
Dearborn said that this large-scale of towns to serve “brings both opportunity and challenges,” but added that local communities are able to find answers to their questions more efficiently and accurately through the council.
“Some of these collaboration efforts consist of quarterly meetings with health inspectors to review standard operating procedures,” she said. “We have quite the variety of expertise within our inspection departments, and so we are really fortunate that a lot of meetings will consist of engaging discussions where things get solved in real time that maybe one person just sitting behind a computer or maybe thinking to themselves couldn’t have reached that final conclusion.”
Amherst’s public health director Kiko Malin spoke to some of the difficulties local towns have with securing adequate resources.
“We’re a bigger municipality in the collective of 14 … even though we have more resources than say Middlefield, we do have challenges for a small department,” she said.
Malin added that HPHSSC is a valuable resource to get answers to complex problems and that the state funding to counteract crucial public health concerns has been vital, including a program to administer vaccines to the homebound.
Another organization represented around the table was The Franklin-Hampshire Training Hub — one of 10 statewide training hubs in the state focused on educating inspectors and offers training for members of local boards of health.
Bri Dupras, the lead public health trainer with the hub, outlined her work that includes reviewing inspector reports, giving feedback, and training inspectors on how to adequately inspect facilities, from kitchens to houses, indoor skating rinks and funeral homes.
When inspectors reach out for help, she said, ‘They call me, and they always say, ‘I’m so sorry, I have a question.’ And I always tell them, I get paid 40 hours a week to answer your questions.”
Out of all the conversations that took place on Monday, one thing in particular stood out to Mahaniah, and that was rates of hoarding.
Dupras said that often the homes of hoarders have messy front yards and covered windows. While on average about five homes are classified as having a hoarding problem a year, she said that there must be “hundreds” that are currently off the radar.
Mahaniah attributes hoarding to a public health problem that has worsened since the pandemic to isolation, and called on organizations to “recreate community for people that somehow fell out of community.”
By the end of the hourlong discussion, Mahaniah shared his takeaway of the discussion, reflecting on balancing the impact of larger state systems, and the impact individuals have on their communities in the relam of public health.
“Sometimes it’s great when you have these big systems where you can put a lot of effort into it, but sometimes we forget about the efficiency of having somebody who knows the community, knows individuals and who’s able to cross all these different parts of people’s lives that are important,” he said.