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Board of Health roundup: Nursing finances discussed; post-COVID initiatives continue

by | Mar 28, 2022 | Featured: News, News

They still have to approve it when a final version comes back from the town’s legal counsel, and they already have approved the Town Meeting article, but Board of Health members Monday night voiced support of a revolving account for the Health Department’s nursing division.

The 53 1/2 expense revolving account, allowed under Massachusetts General Law, would create a separate account for the nursing side of the Health Department, according to Health Director Shaun McAuliffe and Public Health Nurse Simone Carter, and would create more transparency.

“Our request and our argument is that reimbursements for any work that we can obtain, Medicaid, Medicare or private insurance reimbursement, we should be collecting those fees,” McAuliffe said. “That money can come into the public health nursing account and can cover the cost of vaccines that aren’t covered by the state; all the equipment, PPE [personal protective equipment], necessary for that; and then materials to support the Community EMS [emergency medical services] program, testing for COVID, RSV [respiratory syncytial virus], the flu and other work.”

“If we run this properly,” he continued, “similar to what was done in Sudbury, [that town] used to pull in on average about $80,000 a year. So there’s a substantial benefit to us setting up the fund and moving to this model. It’s a good model. It’s a good way to sustain our efforts [and] allow us to expand some of our service capabilities.”

The request currently is under review by legal counsel. When it comes back to them, board members will vote on it, Chair Lisa Whittemore said.

“Sounds wonderful,” she said. “Given some of the challenges we had with some of the billing issues for the vaccine administration, is that going to happen with this, or is this something we are able to manage on our own?”

Responded Carter, “What it will do is ensure that our funds that were generated by our actions as a Health Department … stay within the Health Department. That way, when they’re expensed out, and we have to put expenses out for next year’s flu vaccine, or we get a shingles program going … however we decide to do that, we will then have a mechanism in place to fund ourselves.”

Board of Health Member Rick Jacobs raised the issue of transparency, saying he wanted to make sure there was a clear way of showing the proceeds and use of any funds going forward.

That, said Carter, is precisely what the fund would accomplish. She pointed out it still will be administered, in some part, by the accounting department.

“It is completely transparent,” Carter said. “One of the things that really stands out to me is that, having come from the private sector, I am very sensitive to folks wanting to see what their money is doing. Always, there has been criticism about public health, that we aren’t able to support ourselves or provide services that are even meaningful.

“This takes the guesswork out. There’s a paper trail a mile long that says this is what came in, this is the vendor that deposited into our account, and then, ‘Hey, we’re going to buy masks.’ … It’s actually more transparent than if it were just buried in the Board of Health account.”

Post-COVID work continues

The Health Department continues working on a number of fronts as COVID becomes less of a focus, although cases have risen a bit in town recently.

“We continue to do work with our partners — Youth & Family Services, Senior Center, schools, Fire Department. We’re working to align our departments and continue to break down the silos that existed in the past,” McAuliffe said.

A lot of the work, to start, will focus on benefiting services in the community, as well as continued work on vaping services the town has provided the past three years.

“Everything seems to be coming together quite well,” McAuliffe said.

The department, he said, is embarking on a hoarding and cluttering response sheet that will guide departments in their response going forward.

“We’ll have a list of service vendors we need to get in contact with based on age, health conditions, etc.,” McAuliffe said. “It will make that process work better.”

The department has been working with ClearPath, a nonprofit program that helps with clutter and/or hoarding. That organization, McAuliffe said, has the opportunity to secure a large grant to help the town with emergency services related to hoarding and serious cluttering issues. The town should know in the next couple of weeks whether that grant has been awarded.

“All good things on the public health nursing front,” McAuliffe said.

The department also is trying to figure out how to move forward based on the results of the MetroWest Adolescent Health Survey.

“I think there’s a lot of opportunity for us going forward, both for the public health side and nursing side, partnering with Youth & Family Services, that goes right into vaping and tobacco,” McAuliffe said.

While awaiting the results of the survey, he said, there are concerns about a network that allows youths to order products such as marijuana, tobacco, alcohol or other drugs, and have them delivered to a predetermined drop spot. The department is working with various town departments, including schools, to figure out how to educate youths and provide barriers to accessing those harmful materials.

Booster clinics to be set up

COVID-19 vaccination clinics will be set up, soon, particularly in light of the anticipated approval of vaccinations for children under 5.

“We’ve got plans in place,” McAuliffe said. “We’re figuring out the structure of the clinics we’ll be offering. We have the funds to support all the activities we’ll be doing.”

Some of the clinics, he said, will target Hopkinton specifically, while others will be done on a regional level with the towns of Framingham, Natick, Ashland, Millis, Hudson and Maynard.

Whittemore pointed out that the Centers for Disease Control and Prevention (CDC) could approve a fourth booster as soon as this week, and asked whether the town would mobilize quickly in response or take a more plan-based approach.

“We can handle that,” Carter said. “I have 60 doses that are going to expire if I don’t get them in arms. I haven’t had luck because of our high rate.”

For first and second doses, the town is at 95 percent for vaccinations, while the rate for boosters is reported at 59 percent.

Misc.: Remote meetings to continue

The board on Monday agreed to continue meeting remotely until July 15, when the governor will require in-person meetings to resume.

In addition, the board agreed on an upcoming meeting schedule of April 25, May 9, May 23 and June 6. …

The board at its April 25 meeting will discuss the health director’s evaluation, with Whittemore saying she then would draft materials for the director’s goals and evaluations to be discussed at the May 9 meeting. …

Youth & Family Services will host a discussion titled “Youth Mental Health and Suicide Prevention: What Can We Do?” on Monday, April 11, from 7-8:30 p.m., at the Hopkinton Center for the Arts.

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