I offered the following remarks in a floor speech on July 29, 2022 to support a bill I filed to transform public health in Massachusetts:
Thank you Mr. Presdient, and through you to the members. I rise in support of this legislation.
The bill before the Senate will transform the state’s relationship to local and regional public health. It passed unanimously yesterday in the House.
Because of this bill, a person’s zip code will no longer determine the public health protections they are afforded. Because of this bill, our constituents will lead healthier lives.
With the Governor’s hoped-for signature on this legislation, Massachusetts will set out on the path to creating a 21st-century local public health system.
In 2016 this legislature established a Special Commission on Local and Regional Public Health. It was understood then – long before the pandemic – that our fragmented, under-funded system, with 351 different local health jurisdictions, was broken.
In 2019 the Special Commission issued its report.
In 2020, the pandemic hit.
And the legislature responded, by passing SAPHE 1.0, which stands for State Action for Public Health Excellence that began to implement the Special Commission’s recommendations. We also initiated funding of a grant program – ably rolled out by the Administration – which has been a lifeline for local health departments throughout our Commonwealth.
In 2021, we appropriated $200 million in ARPA funding for local and regional public health, thank you Madam President and Mr. Chair.
Now in 2022, the House and the Senate will provide the policy framework necessary to ensure this funding is truly transformative.
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This bi-partisan legislation establishes minimum public health standards for every community in the Commonwealth.
Currently, Massachusetts does not have a public health framework to guide local boards of health. The SAPHE 2.0 Act directs DPH, in consultation with municipalities and other stakeholders, to develop a set of standards for local public health systems in accordance with national standards and the recommendations of the Special Commission on Local and Regional Public Health. The standards include 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 clinical care.
It continues the work to encourage and incentivize shared services and regional partnerships across jurisdictions. And it focuses on workforce credentialing and training.
The bill strengthens data collection and reporting. Currently, we don’t capture how many food inspections are done, the number of violations, what kind of violations. We don’t capture the number of housing inspections or the extent or type of housing violations. We have no central registry of wells – where they are, how deep they go, how much water they give out – or the quality of the water. That ends with this bill. Because you can’t fix what you can’t measure and the public can’t see. The SAPHE 2.0 Act creates a uniform reporting system which includes metrics for inspections, code enforcement, communicable disease management, and local regulations.
The bill directs DPH to set up a framework for dedicated state funding for local public health. Massachusetts is one of the only states that does not provide dedicated state funds to local public health departments. That ends with this bill.
Finally, the bill recognizes that the best way to deliver public health services today may not be the best way tomorrow, and so it revives and continues the productive and groundbreaking Special Commission on Local and Regional Health.
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The Legislature and Administration were, of course, not alone in responding to the pandemic.
In fact, it was our local health officials who have been on the front lines.
As many in this Chamber know, as COVID tore through the Commonwealth, it exposed grave and cavernous racial and economic inequities.
Dr. Craig Andrade, Board of Health Member in the City of Brockton and Associate Dean of the Boston University School of Public Health reflected, “When a community is overwhelmed with cases, and staff are not able to quickly implement contact tracing, provide education and recommend isolation and quarantine, more people get sick and more people die. And because we currently fund local public health entirely at the municipal level, more of those avoidable illnesses and deaths occur in low-income communities, often communities of color.”
Grievous realities – understood by this Senate and addressed in this important bill.
This bill says to all local officials, to our people – the Commonwealth will be ready next time. To educate, enforce, test, trace, quarantine, monitor, vaccinate – all equitably, rooted and supported in local communities. That work – of course, on top of an already long list of necessary public health measures – is worthy of state investment.
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I share this bill with two extraordinary colleagues, Representatives Denise Garlick and Hannah Kane.
Their leadership is paramount.
As is the stellar organizing and advocacy of the Massachusetts Public Health Association and allied organizations.
As is the service of Secretary Marylou Sudders and the teams at DPH and HHS.
As are the public health officials in 351 cities and towns who wake every morning with one goal, largely still unseen by any of us but as necessary as the air we breath, the water we drink, the food we eat: To make us well and keep us well.
Before closing I want to thank Brian Rosman, legislative director from my team and Chief of Staff Jared Freedman for their painstaking work on this legislation. Please let me also extend thanks to the teams in Senate Ways and Means and the Senate President’s office for all the good represented in this bill before us, especially raising up Colby Dillon and Tovah Miller.
My thanks as well to the Gentle and fierce lady from Arlington who has backed this bill with all her smarts and to the Senate President and Ways and Means Chair who are – without question – unparalleled public health champions.
I respectfully ask for my colleagues’ support and I ask when a vote on this legislation is taken, it is taken by a call of the yeas and nays.
