Like the police and fire departments — minus the flashing lights and sirens — public health is central to keeping people safe. From food safety to vaccines, communicable disease tracing to disaster preparedness, substance use prevention to traveling meals, public health departments have broad mandates and high expectations for their services. According to a 2019 Blueprint for Public Health Excellence from the Commonwealth of Massachusetts, “No other government agencies are as far-reaching — and invisible — as local public health departments.”
The Needham Board of Health oversees these activities in our town. Massachusetts is unusual in having standalone boards of health for each of its 351 cities and towns, many formed over a century ago. In most other states, public health is governed at the county or regional level.
Needham’s Board of Health has five elected members — more than most surrounding towns — each with a strong background in health-related fields. The longest-serving member, Ed Cosgrove, said in Needham “you can’t throw a stone three feet that you don’t hit somebody with an advanced degree. We’ve been lucky to have always had dedicated professional people on the board.”
The current members are: Ed Cosgrove (Ph.D.), Stephen Epstein (M.D., Master of Public Policy); Robert Partridge (M.D., Master of Public Health); Tejal Gandhi (M.D., Master of Public Health), and Kathleen Ward Brown (Doctor of Science). They meet monthly in a publicly accessible forum; recordings can be viewed on the Needham YouTube channel.
The Public Health Division, one of four divisions under the town’s Health and Human Services (HHS) department, carries out the actual work. HHS director Timothy McDonald is designated as the agent of the Board of Health; his group implements the board’s goals and policies and turns their ideas into action. Besides Public Health, Needham HHS includes Youth and Family Services, the Council on Aging, and Veterans Services.
Who works in the Public Health Division?
McDonald was hired in 2014 and promoted to be the first HHS director in 2017. His background is in health care policy and disaster preparedness; he originally worked with Boston hospitals and for the state, including at the time of the Boston Marathon bombing. He notes that Needham’s HHS structure, having one manager across multiple divisions, allows for collaboration and opportunities to work together.
The Public Health Division has two assistant directors, Tiffany Benoit and Tara Gurge, who run the day-to-day activities.
Who funds Public Health activities?
Unlike in other states, public health in Massachusetts is mostly funded at the local level. The annual budget for all of Needham HHS is approximately $2.5 million. According to a town budget proposal, that’s in the same ballpark as the library. Of the HHS’s $2.5 million, the Public Health Division’s share is approximately $1.2 million.
Having a dedicated HHS director with time for strategic planning primes the pump for significant additional funding from grants (federal, state, nonprofit). Grants can bring in more than $1 million dollars annually (last year, $1.3 million). Examples of current funding sources include a grant from the MetroWest Health Foundation to address mental health challenges in Needham’s growing senior population, and awards from the federal Drug Free Communities program, which has provided Needham $1.25 million over 10 years to fund substance use prevention.
What do they do?
According to McDonald, when public health is working well, you don’t see it. If restaurants are inspected regularly, then there isn’t a foodborne illness outbreak. Needham alone has 170-180 food establishments (restaurants, cafeterias and public kitchens).
The public health staff also prepare behind the scenes to respond to critical public health threats, such as the COVID-19 pandemic, which required a nuanced approach to tracking cases and providing resources while protecting individuals’ privacy.
Some of the areas Public Health oversees include: public health nursing and vaccine clinics; environmental health and inspections; epidemiology and disease tracking; traveling meals; emergency preparedness; substance use prevention; mental health promotion; first aid, CPR, and Narcan training; and biosafety permits.
Many services are available at no cost to Needham residents.
Need a flu shot or COVID vaccine? Prefer to get them from a nurse? A few vaccines are left, although most flu shots have already been used. If you do not have insurance, you will not be charged. You can get free COVID rapid test kits, too.
Stuck at home, unwell, and unable to get to the grocery store? The traveling meals program will deliver up to two meals a day to your home. The delivery is free, and the meals are at low cost from the Beth Israel Deaconess Hospital-Needham. The division also can help connect people who have food insecurity to the right services.
Want to learn CPR? The Public Health Division will run a class for you or your group. Think Girl or Boy Scouts, babysitters, or anyone who wants to be prepared to save a life.
High school student who needs community service hours? You can volunteer at the Public Health Division.
Worried about falling? The division runs educational programs at the Center at the Heights to help with balance and other ways to reduce the fear of a fall.
Concerned about heating your home this winter or receiving a shutoff notice? There is a “gift of warmth” program to help connect you with services and pay the bills to keep the heat on until other forms of assistance kick in.
Narcan, the opioid reversal drug, is available in a nasal spray; anyone can register to learn to administer it (training takes a few minutes) and will receive two doses to keep in case of an overdose emergency. According to assistant director Benoit, 115 packages (each containing two doses) have been distributed since August.
What doesn’t it do?
Some areas are outside the board’s and the Public Health Division’s purview.
They cannot inspect or regulate personal property. They do not regulate medical practices or hospitals, those are regulated at the state level.
While they can make recommendations, they have no oversight over alcohol sales (that’s the Alcoholic Beverage Control Commission and the town manager’s office and Select Board). The Public Health Division helps with compliance checks and training.
Needham resident Jennifer Tirnauer is a physician.