Compared to some of the other contests this election cycle, the race for two seats on the Needham Board of Health has been decidedly concordant. The two incumbents say they want to stay the course and keep helping the community, and the challenger, while wanting the board to do more, is also willing to say that the current board does a good job.
On many issues, all three candidates — incumbents Stephen Epstein and Tejal Gandhi, and challenger Khristy Thompson — generally agree. They were all supportive of the board’s recent introduction of age-gated tobacco policies, barring people born after a certain year from buying tobacco products in town. At a recent League of Women Voters forum, all responded to a question from the public about the use of vaccines by strongly supporting vaccination; they all said they think the town is well-prepared to deal with most public health emergencies; and they are unified in their belief that the board should work to address mental health issues in both the young and elderly in town.
Where they differ, or at least take different approaches, comes in how they view agreed-upon common problems. All are concerned about potential federal funding cuts to programs the town depends on. What they focus on, or how they hope to solve them, brings slivers of daylight.
“We need to be watchful for those supports (for) food stamps and so thinking about nutrition and food availability for those that are in need in our community,” said Thompson, who is a clinical mental health counselor at Advocates Community Counseling after years spent as a research scientist.
Epstein, who spent many years in emergency medicine at Beth Israel, focused on the town’s substance abuse efforts, and specifically how grant funding for those could be impacted. Like the other candidates, he worried more broadly about the trickle-down effects if Medicaid funding is cut.
“Cuts coming to the Medicaid program, which funds so much of the social drivers of health infrastructure that we use for the town could indirectly threaten us as well; some of the funding from the state that comes to our health efforts might be redirected elsewhere in order to meet those budgetary needs,” Epstein said.
He said that finding alternate funding sources for those could be key.
“I’m hoping that we can preserve the funding we have and work with Town Meeting to secure that for the future for the town.”
Gandhi, who works in patient and workforce safety at Press Ganey after years as a practicing doctor, a healthcare executive and as president and CEO of the National Patient Safety Foundation, echoed the concerns about Medicaid, and about specific grant funding. She raised other possibilities for backfilling that funding, including going outside of government to make up the difference.
“We’re going to need to identify other potential funding sources, given the risks to some of the federal dollars, and think about philanthropy,” she said. “Think about private funding sources, etc, because these dollars contribute to the health of our community.”
One of the Board of Health’s responsibilities is for food safety in town, and over the past half-decade they have been aggressive in introducing new food standards, which Epstein said come from new federal mandates.
“We’ve done a massive job in food safety,” Epstein said.
At times that has brought them into conflict with some of the town’s restaurants, but Epstein said overall the process has moved fluidly.
“I think we’ve got a good partnership with the food establishments in town … we were a little bit concerned about, you know, some of the smaller restaurants: were they going to be able to comply with the new food code? They have been,” he said.
“That’s not to say that we have not had a couple of restaurants that have had problems,” Epstein acknowledged.
The most prominent example is that of Rice Barn, the Great Plain Avenue restaurant that was cited by the board for health violations and then closed by them in May of 2022. The restaurant’s owner went before the board seeking to re-open on several occasions over the past few years but did not get clearance and ultimately left the space this past winter.
That’s not the outcome the board wants, Gandhi said — they are looking to get restaurants into compliance, and there are examples of restaurants operating now in town that had health issues and have since cleared them up.
“We’re not trying to set unachievable standards, but we are trying to make sure that people go into restaurants and don’t get sick, right?” Gandhi said. “And there’s usually multiple rounds of coaching and follow-up inspections and bringing in consultants to help them with food safety and other things. And it has been challenging.”
Thompson said she is looking forward to working on food safety issues if elected.
One area of debate among the candidates was the Board of Health’s statement on the MBTA Communities Act, released prior to the October Town Meeting vote. The Board of Health discussed the benefits of the base versus neighborhood plans extensively last fall, when the plan was due to come before Town Meeting, and ultimately came up with an approach that supported passing the base plan while advocating for going beyond it in some way but stopped short of endorsing the neighborhood plan itself, according to Epstein and minutes from the meetings.
Epstein said he was very supportive of increasing housing overall in Needham, but personally had reservations about the extent of the neighborhood plan, while Gandhi was supportive of the neighborhood plan. Thompson was not involved in the board’s discussions, but said she would want to take a graduated approach to introducing more housing in Needham.
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