SENATE, No. 678

SECTION 1.  Section of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting after section 3B, the following new section:--

Section 3C . State aid for Public Health; determination

Section 3C. The state treasurer shall annually, on or before July first, pay from monies appropriated from the Local Aid Fund for the purpose of improving and sustaining the effectiveness of public health services and disease prevention, to each city or town certified by the public health council to have met certain minimum standards of public health programs and services established by said council, an amount to be used for the administration, delivery of public health services and disease prevention of said city or town, to be determined as follows:—

(1) to each town having a population of less than two thousand five hundred, a sum equivalent to the amount appropriated by it for the board or department of public health during the preceding year, but in no event more than one thousand two hundred and fifty dollars;

(2) to each city and to each town having a population of two thousand five hundred or more, a sum not exceeding fifty cents for each resident therein; provided, however, that such city or town appropriates during the preceding year for its board or department of public health at least one thousand two hundred and fifty dollars;

(3) to each city and town or to a region, in addition to the amount specified in paragraph (1) or

(2), an additional sum determined by allocating the remaining available amount among the cities and towns based on the leading health indicators as established by the council and an assessment of the funding needed to address the top three health indicators of each community or in a region;

(4) in addition to the amounts specified in paragraphs (1), (2) and (3), to any city, town, or region whose public health needs are so extensive as to be designated “a community or region of critical health concern,”  by said public health council, an amount for the purpose of offsetting the costs of extending aid to assist the said community or region of critical health concern. Said amount shall be determined by said council by allocating the sum appropriated for this purpose according to criteria and formulae developed by said council in consultation with the appropriate public health region established under section 4 of this act.

No city or town shall receive any money under this section in any year when the appropriation of said city or town for the board or department of public health is below an amount equal to the average of its appropriation for the board or department of public health for the three years immediately preceding, increased by two and one-half per cent of said average. Said public health council may, upon petition of a community, waive aforesaid requirement upon demonstration of fiscal hardship. Said waiver may only be granted by said council in a given fiscal year to not more than ten cities and towns in the commonwealth.

In establishing the minimum standards of public health programs and services, the council shall address the action steps needed for improving the health status of the residents of the commonwealth through an assessment of, and action steps for addressing, the leading health indicators including, but not limited to, Physical Activity, Overweight and Obesity, Tobacco Use, Substance Abuse, Responsible Sexual Behavior, Mental Health, Injury and Violence, Environmental Quality, Immunization, and Access to Health Care. 

SECTION 2.  Section of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting after section 3C established by this act, the following new section:--

Section 3D. State aid for Public Health; annual reports by local health agencies; requisites for aid

Section 3D . The public health council, in setting up minimum standards for local public health services to address deficiencies in the leading health indicators and in certifying such local boards of health or departments of public health for aid under section A shall require the filing of an annual report with the state department of public health and with the house and senate chairs of the joint legislative committee on public health, the house and senate chairs of the joint committee on mental health and substance abuse, the house and senate chairs of the joint committee on health care financing, and the chairs of the house and senate committees on ways and means, and shall require that such boards of health or departments of public health:

(1) serves all residents of the commonwealth residing in the respective community,

(2) make no charge for normal public health education and prevention services except to cover cost of such service and, provided, that such service shall not be denied to any person because of inability to pay any applicable fee,

(3) employ trained personnel in accordance with regulations promulgated by the public health council,

(5) expend a reasonable portion of the board of health’s or department of health’s total budget on prevention,

(6) cooperates with other local boards of health and departments of public health, regional public health agencies, the state department of public health, and the centers for disease control and prevention,

(7) include in their annual report the expenditures and source of funding, which shall be subject to an audit by the state auditor.

SECTION 3.  Section 4 of chapter 111, as most recently appearing in the 2004 Official Edition, is hereby amended, by striking the current title, and inserting a new title, and by inserting at the end thereof, the following paragraph:

Section 4. Regional public health services; annual appropriation

     The public health council shall establish a comprehensive statewide program of regional public health services, consisting of regional offices of the state department of public health, which shall not exceed eight, for the purpose of providing reference and research services, interagency loan, delivery, and other regional services to boards of health and public health departments, community health centers, school-based health centers, area health education centers, health education training centers, and other public health entities in the region. For each public health region, the council shall designate a lead administrative agency which may, if appropriate, be the area health education center. For such purpose, there shall be an annual appropriation which the council shall apply in the following manner:

(1) Insofar as practicable the council shall enter into an arrangement or arrangements with such public health departments in each regional area as it may determine under the terms of which such public health departments shall supply services or space, equipment, personnel, supplies, inspectional and enforcement services and other public health materials to communities having fewer than twenty-five thousand inhabitants;

(2) Any regional public health service under an approved plan shall be entitled to receive annually in state aid an amount per capita of its served population per square mile of the area served in accordance with the schedules established by the council.

(3) Any employee employed in a position identified as a regional position in a public health department which accepts funds under this section shall not be required to comply with residency requirements. For purposes of this section, “regional position” shall mean a full-time or part-time position for which at least fifty per cent of the funding is provided by the commonwealth pursuant to this section

SECTION 4.  Section of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting after section 4 as amended by this act, the following new section 4A:--

Section 4A. Regional public health service; council of members

Section 4A. For each regional public health service, the public health council shall establish a regional public health service advisory council which shall consist of the chairman of the board of health, commissioner or director of the local department of public health or another board of health member or departmental officer to be so designated by the board of health or commissioner or director, as the case may be, or other appropriate administrative authority of each participating community and one designated representative from participating school based health centers within each public school district and one representative from the participant from each visiting nurse agency and acute care community hospital or community health center  within each public health region. The duties and responsibilities of the council of members shall be specified in the bylaws of the public health regions as approved by the public health council.

SECTION 5. Section of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting after section 4A as established in this act, the following new section:--

Section 4B. Public health services; comprehensive statewide program; funds; standards

Section 4B. The public health council, hereinafter called the council, shall, subject to appropriation, establish a comprehensive statewide program for the improvement of public health for all citizens and the improvement of the health status of all residents of the commonwealth. Such funds as may be appropriated shall be distributed by the council for the following purposes:

(1) for the establishment of statewide inter-operative technology system for the communication of public health information and public health emergency information, and for monitoring public health conditions;

(2) for the establishment and development of cooperation and coordination among public health agencies, including the authority to:

(a) provide coordination and administration of cooperative statewide public health programs or services and statewide coordination of regional programs;

(b) provide for identification and tracking of critical health indicators;

(c) provide statewide access to specialized health resources and public health information services, including, but not limited to the National Library of Medicine’s Medline Plus program at the University of Massachusetts Medical School;

(d) participate in interstate public health services if such participation will increase the availability of public health services to the commonwealth and its political subdivisions;

(e) provide statewide delivery of public health services;

(f) provide education, training and technical advisory services; and

(h) provide funding for grants for projects that demonstrate innovative uses of technology, interagency cooperation or shared services delivery to improve public health service delivery to residents of the commonwealth and local health agencies.

For the establishment and development of public health information and referral centers in state institutions in conjunction with area health information centers.

In making grants under this clause the council shall establish minimum standards for such public health information and referral centers which take into account:

(a) the type of institution;

(b) the size of the resident population and key health indicators for that population;

(c) the availability of public health services to the area population;

(d) the qualifications of personnel for staffing of a public health information and referral center;

(e) the institution’s commitment to annual budgetary support for public health information and referral services.

For the establishment and development of public health information and referral centers of all types to the handicapped and disadvantaged including:

(a) the establishment and development of public health information and referral services and centers for persons whose native language is not English. The council shall establish standards for such services and centers;

(b) the development of public health information and referral services for the elderly, the unemployed, the poor, the functionally illiterate, and those persons who have cultural, social, or educational disadvantages that lead to health care disparities or prevent them from using public health information and referral centers and services designed for persons without said disadvantages;

(c) the establishment and development of public health information and referral services for persons who are visually impaired, mentally, physically, or emotionally handicapped.

To aid public health planning, construction and re-construction, the council shall adopt standards to be applied in allocating funds for these purposes.

To conduct, contract for, fund or publish studies relative to public health needs and services of public health information and referral centers of the commonwealth. The funding of such studies shall be for the purpose of advising the council in carrying out the provisions of this section. Such studies may include the testing and evaluation of findings by the council.

SECTION 6. Section of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting after section 4B as established in this act, the following new section 4C:--

Section 4C. State assistance for public health projects

Section 4C. The public health council shall, subject to appropriation, establish and administer a program of state assistance to cities and towns in the planning, reconstruction, construction, design, acquisition or lease of real property, renovation, preservation, rehabilitation, demolition or expansion of a facility to be used as a community or school-based health center, public health clinic.

The council may, in accordance with the provisions of this section, provide grant funds to such cities, towns, or non-profit corporations which apply for funding of projects authorized by this section; provided, however, that said grant shall not exceed seventy-five per cent of the cost of an approved project, including interest and the cost of planning thereof.

SECTION 7. Office of Local Health Services.

Section 2 of chapter 111 of the general laws, as most recently appearing in the 2004 Official Edition, is hereby amended by inserting at the end thereof, the following new paragraph:--

     The commissioner of public health shall, subject to appropriation, establish an office of local health services to provide coordination of state health policies and programs with, and provide support for, local public departments and boards of health in all cities, towns, and regions including, but not limited to providing: technical assistance for strengthening public health administration, planning and preparedness grants for public health emergencies, training of public health officers, health information infrastructure grants to develop local health information capacities and consistency with the national health information infrastructure, infection disease prevention and control to respond effectively to epidemics and disease outbreaks, and building a regional network with public health agencies health care providers, and emergency management agencies.

     Said commissioner shall, subject to appropriation, appoint a regional pandemic planner for each public health service region, established pursuant to section 3 of this act after consultation with the regional public health service advisory council established pursuant to section 4 of this act to assist communities within said region with formulating and exercising local and regional pandemic health emergency plans including, but not limited to, an inventory of services, equipment and supplies needed to implement said plans.

Section 8. Effective date.

This act shall take effect on July 1, 2008.