ORDER-2023-32 : Health and Human Services Regionalization Project (previously INFO 2023-7, corrected to appropriate legislative file)

Transcript (~16 min @ 2:36:00)

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▶ 2:36:22 Speaker 5: We're done. All right, we're giving

▶ 2:36:29 Jack Eccles: back in the health education welfare committee. Maybe the latest one we've seen ever the only order. We haven't tonight's agenda is order 2023-32 Health and Human Services regionalization project previously info 2023-7

▶ 2:36:51 Jack Eccles: Is there we have the health director in the mayor with us this evening? Is there a motion to suspend the rules?

▶ 2:36:57 Robb Stewart: Mr. Chair, I'll make a motion to suspend the most to spend

▶ 2:36:59 Jack Eccles: the rules made by counselor Stewart seconded by counselor McMaster on favor. I will opposed rules are under suspension near rotor

▶ 2:37:10 Paul Brodeur: director. Thank you, Mr. Chairman. This is a little bit of kind of Back to the Future story to a certain degree while we'll recall that back in the day Melrose and Wakefield combined there health Apartments and at a very successful collaboration so successful. In fact that reading came on board. I don't remember the exact time but 70 several years later and that proceeded for several years before reading dropped out of that Coalition. We now have the opportunity to essentially grow it in a little bit of a different way with a arguably more cohesive set of partners by inviting really an invitation but welcoming Stoneham who was expressed a great desire through to their process and Wakefield is on board as well to expand once again, and I will leave it to Anthony to go into the the details of the benefits, but certainly I would point out the Some mild cost savings, but obviously no money should be. Looked a scans at but the opportunities to really scale in three similar communities to work on a lot of things particularly Public Health Grants that are really becoming more and more available around. Some of the more true Public Health functions around things like mental health and wellness vaccination disease prevention things like that. So I think it is a terrific opportunity for us to go back down this road. And with that I will leave it to the director

▶ 2:38:55 Speaker 1: thank you. Miss. Mayor. So currently Melrose and Wakefield are very successful relationship combined to health departments were able to work on a lot of different projects that tie in our Council on eight. Our partner and Council on Aging is our school districts and our substance use prevention coalitions as well as our minimum statutory requirements in health inspections and public health nursing. I think a lot of our shared functions can benefit from further collaborations. So we already informally work with a lot of different parties within Stoneham a big shout out to Stone and boys and girls club. They do a great job in terms of their programming their camps as well as their substance use prevention efforts in their Coalition as we all know the opioid epidemic and the Mental Health crisis is a top priority and one of the things that we're able to more successfully do to address this is to apply for certain grants that give us more tools. We are in the same region as Malden and Medford with Population of around 60,000 with the inclusion of Stoneham we would be roughly about 80,000 in population that puts us in line for some of these larger state and federal grants. I think this doj grant is a good example of a potential collaboration and benefits that we can reap from this. I think the further collaboration and standardization of practice. So with Stoneham being so close geographically and facing similar surface and similar health concerns. I think it's a it's a logical fit between these three communities. We currently have a certain set of standards for how we conduct Health inspections. We try our best to follow the FDA standards and if we're able to bring in stone and we're able to standardize that practice across the three communities not to mention I think part of part of this. Part of this agreement would allow us to save in the ballpark of 23,000 a year if we were to share so the nuts and bolts of this agreement would be a share between myself the director position the senior health inspector position and the public health nurse these three staff. We are the senior staff for the health department. We would be a shared resource across three departments and we will be looking for Stoneham to basically take on dedicated staff to make sure that our resources are not diluted across the third community. And so we're able to maintain services that we're currently providing for Melrose and Wakefield, but also be able to bring Stone them up to speed in terms of what we're what our standards are here. So I think it's it's important work that we could be doing and I think even though we already have an informal partnership to be able to bring Stone them in into how kind of the same operations across the board would be very helpful. counselors as you speak Council Williams I'm just getting started. It says here there would be established a Regional Board of Health. Correct? So after discussions, I think looking at the blueprint for public health excellence in the state of Massachusetts, I think regionalization is best as best executed when there is maintenance of independent Boards of health. So I think that would change in the boards of Health have their own specific mandates within Mass General law, so that would remain separate for the three communities because the three communities while similar in certain aspects should remain autonomous. So we would have a Melrose Board of Health and then a millstone wakeboard of Health, basically. So the original proposal hopefully would maintain just a Melrose sport of Health Wakefield waterfallon Stone and Board of Health there could be discussions. I guess of a combined Board of Health, but I think right now we're talking about three autonomous ones

▶ 2:42:36 Paul Brodeur: if I'm making out so the the Particularly when the pandemic was a frequent meeting situation. My memory is that there were memory there were memories of memories. I'm sorry. There were meetings of the Wakefield Board of Health together with the Melrose Board of Health. for efficiency as much as for you needing a super majority of both bodies to move forward with particular positions in in either Community or programming within either community.

▶ 2:43:09 Speaker 3: Okay.

▶ 2:43:12 Speaker 1: What's your what's your take on how this would impact? Health enforcement So you add Stoneham to the mix does that give us more enforcement capacity or less enforcement capacity? Well, I think in terms of forcing we're talking specifically about food potentially trash dumpsters and housing inspections. So across the board, I think adding Stone and would actually allow us to have more enforcement capacity. I'm going to reference the rodent rodent example, so I think though we see wrote an issues here in Melrose. I think we have to frame this in a contextual kind of regional format and I think practices done in other in other surrounding areas will affect what we see here. And so if we're able to kind of across the board have standard practices that address like the rodent issue including trash and dumpsters. I think a more comprehensive approach to actually allows to have a better result across the board. So you think the Melrose rats sometimes go to Stoneham the stone and rant sometimes go to Melrose. I'm pretty sure rats don't respond to timelines. That's it. No questions. Thank you. Any other counselors this question counselor Master? Thank you

▶ 2:44:22 Shawn M. MacMaster: Mr. Chairman. Thank you for being here. What is the health department Staffing look like in the other communities right now?

▶ 2:44:28 Speaker 1: So currently Melrose we have I'm gonna run through the list right now, but we currently have a shared senior health inspector that's between Melrose and Wakefield. We have a public health nurse that is shared between hours and Wakefield the senior health inspector oversees two full-time inspectors one dedicated to Melrose one dedicated Wakefield the public health nurse oversees one part-time public health nurse assistant public health nurse in the town of Wakefield, and currently we have in Melrose a public health specialist formally known as a substance use prevention coordinator. We have an administrative assistant we have The tobacco inspector Maureen Busby who's more of a regional position housed here, but correct tells housed here where we're the host Community. We also have Kara showers prevention and wellness coordinator part-time and we also have delicious a lot of people. I believe I believe that's it in Melrose and then Wakefield. We have a assistant Health director Catherine dingra who does substance use prevention coordination and grants coordination. We have an administrative assistant and we also have a social worker. Oh, so we have social services coordinator full-time in Melrose and one social services coordinator full-time and Wakefield we all so have a Full-time health inspector in Wakefield as well.

▶ 2:45:51 Shawn M. MacMaster: Thank you. So from a staffing perspective, what will Stoneham contribute

▶ 2:45:56 Speaker 1: to the partnership sole Stoneham will be asked to contribute one full-time inspector and one and part-time one part-time assistant public health nurse the inspector, the full-time inspector will report directly to the senior health inspector, which is the case right now from Melrose and Wakefield and the assistant public health nurse part-time would report to the public health nurse. That's currently overseeing the assistant Public Health nursing Wakefield. Thank you clarified.

▶ 2:46:18 Paul Brodeur: Just one thing real quick is he said we'll be asked to that is actually the commitment they're making it's part of the deal. Yes, so it would be set in stone.

▶ 2:46:29 Shawn M. MacMaster: And are we able to to pull? Staff from both communities in Melrose and vice versa, you know, if needed under your approval from whatever reasons whether it's an inspection or or something else through this

▶ 2:46:42 Speaker 1: partnership. Yes, so currently the practice right now for Melrose and Wakefield is we have pretty we have some higher risk level inspections generally and best practices to have more than one inspector go at a time. So we currently have them collaborating on certain inspections. There are times when one may be out for any reason or and the other one will come in cover. So we will we will have the capacity to basically shift resources to make sure that all bases are covered.

▶ 2:47:07 Shawn M. MacMaster: And what would be the reporting structure for you? Because you have three different. communities with three different Executive we have a mayor and Melrose, I believe it's a Town Council and Wakefield. And is it a town Constable to select them? And so how does that work in terms of I'm just trying to avoid uncertainty in terms of who you report to what that structure looks like and what that oversight looks

▶ 2:47:32 Speaker 1: like. So currently the arrangement is I am a city of Melrose employee my report directly to the mayor and the City of Melrose in Wakefield. The they have a Town Administrator. They all have a Town Council and so we do report our functions to them but the mayor and Town Administrator and Wakefield currently the setup. They have great collaborative relationship. If there's any of there any ever any concerns, they usually consult each other on things. So generally I do report directly to the mayor but I obviously work very closely with the administration and Wakefield. The idea would be for this relationship to also be the same Windstone comes on board. I'd be working closely with our town

▶ 2:48:12 Paul Brodeur: leadership too. It's roughly analogous obviously different communities. About the veteran service officer district and you

▶ 2:48:17 Shawn M. MacMaster: mentioned the 23,000 cost savings. Where is that? What is that savings come from? I didn't see that. So the

▶ 2:48:23 Speaker 1: cost saving comes from the shared salary that's being distributed myself the senior health inspector and the public health nurse a three of our sellers would be distributed further. There is an increase in each of our salaries, but with that increase and then distributed across three communities. We are saving roughly 23,000.

▶ 2:48:42 Shawn M. MacMaster: And mayor, you mentioned the commitment that's done and would be making how is all of this codified. Is there a memorandum of understanding between the community signed by

▶ 2:48:52 Paul Brodeur: you and then myself and the two towns of industrators? presumably with the authority of the

▶ 2:48:59 Speaker 5: City Council Excuse me with their select board and don't know

▶ 2:49:03 Shawn M. MacMaster: how long the current mou is with Wakefield. Is that is that come up every year every few years, if you know a

▶ 2:49:11 Speaker 4: Believer comes up every three years correct me from wrong. I think there's a

▶ 2:49:13 Paul Brodeur: balance it. There's like like a, you know notice to withdraw Provisions. Don't hold me to that. That's all I

▶ 2:49:19 Speaker 3: have. Thank you.

▶ 2:49:23 Speaker 1: the counselors Seeing now, what is above the community councilor Williams motion to prove to the full board to recommend to the full board. Excuse me.

▶ 2:49:34 Jack Eccles: Second by second motion recommend by counselor Williams taking my counselor Stewart.

▶ 2:49:40 Speaker 1: on favor

▶ 2:49:43 Speaker 1: discussion

▶ 2:49:45 Robb Stewart: Oh, I'm discussion. Yes. I had meant to ask a question. Thank you Mr. Chair for being here. Just just to clarify. I think what console McMaster was alluding to? it sounds like Stoneham it says they're going to Pony up this resource. But we don't have firm commitment yet. Is that accurate or I mean what? Is there any is there anything on our side that we need to be thinking about concerned about if they do not come through with these this one and a half resources. I think

▶ 2:50:21 Speaker 4: the agreement is.

▶ 2:50:26 Speaker 4: The agreement is conditional on them bringing this resource. I think we wouldn't have the added benefit of another town that allows us to have extra resources

▶ 2:50:32 Speaker 1: to basically cover all of our bases if they don't provide these so

▶ 2:50:38 Speaker 4: I think with the mou requirement, we we would not enter this. I don't think we would enter this agreement if we didn't have the adequate resources to

▶ 2:50:46 Robb Stewart: Okay. Okay. Great. Just want to be sure that we're not going to add any additional stress. To our community into your department. If they for whatever reason, you know, if the board is Select them say no or whatever whatever the case may be. Okay, and you feel confident that that won't be impacted.

▶ 2:51:06 Speaker 4: I feel confident now after we've had discussions with them. Both administrators

▶ 2:51:09 Paul Brodeur: have indicated that they don't need. Approval of their essentially their executive board the Town Council in Wakefield and the select board in Stoneham. We obviously kind of leave that to them they know their Their Charter in their rules better than us and that I any appropriating body could conceivably if they wanted to kill it could shut off. Funding for it and that would be the way. The deal would run rival happily that has never been an issue between between us and Wakefield in his Anthony's said the relationships obviously always subject to change but are very strong amongst all three communities. Okay, great. We will not have any Financial commitment whatsoever with that relationship, we would not have to if put bluntly we will not have to carry Stoneham or Wakefield. That's all I need you. Thank you all in