Bolstering our Public Health Structure
By Gregory T. Federspiel
COVID has many lessons for us. For the one, the pandemic highlighted the lack of robust resources most communities have in place to deal with wide-spread community health issues. This is true for Manchester. Our Health Department has operated under a very frugal budget for years and while the structure has served us well, the experiences of the past few years has demonstrated the need for changes.
As part of the FY23 Budget, which began July 1st, the Board of Health (BOH) has been given a green light to recruit a Health Agent to serve as a department leader. Years ago, the Town shared a Health Agent with Essex, and, prior to that, had its own Health Agent. Currently we rely on a part-time administrator, a part-time public health nurse (who put in significantly more hours above their normal routines during the height of the pandemic) and contract workers for Title V work and other inspectional services.
As part of the move to provide a more fully staffed Health Department, the BOH and the Select Board agreed that it would be beneficial to clarify the roles of the BOH and the functional relationship of the Health Department within the rest of Town governance and administration. A new Memorandum of Understanding (MOU) was crafted and approved by both boards recently that defines the roles and lays out a collaborative approach to managing the affairs of the Health Department.
Boards of Health have defined statutory responsibilities. For communities that have elected boards and no local charters or special acts that modify the statutory duties, a local Board of Health has a high degree of autonomy. For us, we have an appointed board (chosen by the Select Board) and the Special Act that created the Town Administrator position with general administrative duties for all Town operations.
The recently approved MOU makes it clear that health directives and policy decisions governing the Health Department rest with the BOH per state law. General administrative oversight lies with the Town Administrator. The hiring of staff is a collaborative effort. For the Health Agent/Department Leader, the Select Board must ratify the hiring of the preferred candidate. The MOU does not convey any new autonomy to the BOH. Rather, it clarifies their role vis a vis state law and the Special Acts that the Town and State have approved.
A Board of Health may promulgate policies and health regulations that protect the public health. Any proposed policies and regulations must first undergo a public hearing process. Drafts of the proposals are made available, and the public is afforded an opportunity to comment and provide input to the BOH prior to them taking a vote. The MOU does not change this statutory process.
Last fall the BOH was given a proposal for new regulations regarding development from the Manchester Essex Conservation Trust for consideration. These proposed regulations would apply to future development with a particular focus on protecting water quality (the new regs would not apply to anything already built or already in the permitting process.) The BOH has not yet decided if they will advance these regulations either in their original form or possibly in some modified form. A lot more work, including advice from Town Counsel and an assessment of how these proposed regulations fit within our existing zoning regulations, will be needed.
Updates on both the hiring of a new Health Agent for the Town as well as progress on any new proposed regulations aimed at protecting our water resources will be provided as appropriate.