Here’s a question that my team and I field over and over again: What’s it going to take?
What’s it going to take to fully reopen? What’s it going to take to reinstate nursing home visitation? What’s it going to take to reopen businesses that are still closed? What about our schools?
While medical experts work tirelessly on a vaccine, the vast majority have acknowledged that it’s still many months from fruition. Yet we know a great deal more about COVID-19 now than we did last spring.
We know that public health requires robust surveillance — testing that’s lighting quick, free, and that’s available to those with symptoms and those without. We know we need contact tracing that catches folks while they’re still contagious. We need data that’s consistent, granular, comprehensive and reliable. Because we can’t see or take decisive and effective action on what we don’t know.
We need funding. Our schools need funding for transportation modifications, for school buildings that cannot reopen due to poor ventilation, for workable broadband and cell service. Small businesses need money to modify their physical spaces, to pay for new sanitization expenses and to stay afloat during the economic downturn. Our community health centers and our hospitals need funding to continue to rise to the pandemic’s challenges and prioritize COVID-19 care above all else.
My 413-legislative colleagues and I have been raising our voices on all of the above and more on behalf of constituents, including advocacy around our local public health system. Because local public health is at the center of it all.
Since the beginning of this crisis, local health departments have been on the front lines of our state’s response to COVID-19, investigating suspected cases, collecting and supplying data to the state, tracing contacts, and recommending and enforcing quarantine and isolation. They’ve been leading widespread public education, enforcing essential business orders and reopening guidance, and providing input to businesses on safe operating procedures. They’re often the central coordination force between town officials, first responders, businesses, and residents, and serve as near-constant communication hubs between local residents and state officials.
They do all this and then some. Keep in mind that they had a full slate of duties before COVID-19 all geared toward keeping us all well. Yet they’re wildly under-resourced.
That’s why, two days ago, I joined with House colleagues Denise Garlick, vice chair of House Ways and Means, and Rep. Hannah Kane to introduce a bill that would accelerate equity and effectiveness of our local and regional public health system.
The problems facing local health systems are not new. Massachusetts has 351 separate boards of health, a stressed system that has led to uneven performance across municipalities. A special commission on Local and Regional Public Health convened in an effort to address this issue, and in June 2019 this commission released a Blueprint for Public Health Excellence.
Unfortunately, the fault lines in our local health system were already showing when COVID showed up. In the March 5, 2020 COVID-19 oversight hearing I convened via the Joint Committee on Public Health, Lisa White of the Cooperative Public Health Service of the Franklin Regional Council of Governments testified that her ability to protect the public was limited by having just one full-time public health nurse — herself — for 14 communities.
The testimony that the committee received was so pointed and charged that it helped propel passage of legislation creating the State Action for Public Health Excellence (SAPHE) Program, which implemented some of the special commission’s recommendations. While an important leap forward, the SAPHE legislation was created pre-COVID-19.
But we’re in the COVID-19 world now — in a world where the pandemic has placed previously unheard of burdens on our local health systems, and exposed a chasm of inequities in terms of the services these systems can provide.
This message was delivered to the Legislature with searing clarity on June 29, 2020 when Sens. Adam Hinds, Cindy Friedman, and I led a reopening hearing focused on public health and health care. Speaker after speaker discussed structural deficiencies and glaring gaps wrenched open during COVID-19. Gaps and deficiencies that demanded a more comprehensive approach. At the same time, local public health officials in our region made it clear that our current path is completely unsustainable.
Enter — essentially — SAPHE 2.0.
The goal of this new legislation is to build a more equitable system that will provide essential public health protections to all Massachusetts residents by:
- Ensuring that every resident has access to a core set of public health protections;
- Establishing minimum public health standards for every community;
- Increasing the capacity of our public health colleagues;
- Creating a uniform data collection and reporting system; and
- Providing adequate and equitable state funding.
Faced with the inequities laid bare by this pandemic, we must seize this opportunity to make changes that local public health officials have been demanding for years. It’s an ethical response to COVID-19 and the pandemic’s grave impact.
We must do better for these boards of health and public health officials, better for our municipalities, schools, small businesses and elders. We must do better for our colleagues on the front line of this pandemic. And we must do better to honor those who have suffered profound losses.
We must do much better in all our efforts to address what it’s going to take to reopen our commonwealth safely and securely.
State Sen. Jo Comerford represents 160,000 people living in 24 cities and towns in the Hampshire, Franklin, Worcester district in the Massachusetts Legislature.
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