Board of Health notes: Budget and staffing issues; Flu clinic plans

by beth on May 12, 2020

The Board of Health was one of the departments charged with providing reduced versions of budgets for the fiscal year starting in June.* At last week’s meeting, the Board was already dealing with financial impacts of pandemic responsibilities at their current funding level.

During last Thursday morning’s BOH meeting, members discussed the issues. They also addressed plans for handling this fall’s Flu Clinic.

Flu Clinic

The Town has already ordered 240 doses of the flu vaccine, but has the flexibility to increase or reduce that. The number is 20% higher than last year, based on an assumption that demand will be higher this fall. 

Following their established Emergency Preparedness Plan, the clinic will be held in the Woodward School gym. It will be coordinated with Southborough Emergency Management and support is expected from members of MRC (Medical Reserves Corp) and CERT (Community Emergency Response Team).

Equipment and budget

In the meeting, the Board voted to purchase a work cell phone for the new Public Health Nurse. Leading up to that was long discussion about the lack of money in the budget. 

The nurse has been responsible for monitoring infected and contact traced residents. Last Thursday morning, Nurse Emily Amico reported there were 35 infected cases (12 still-then active) and 64 residents had been quarantined (15 still were at that time.)

Amico has been doing the work from home without a Town provided cell phone, and, until recently, with a problematic laptop.

To protect the privacy of her personal numbers, Amica hasn’t used her cell to call or text. She’s been calling from her landline after blocking caller ID  (by dialing *67). Amico acknowledged that many people are more likely to answer texts than phone calls or emails. Chair Marylou Woodford noted that many people don’t answer a call from a blocked number. 

Because the former nurse had used one cell for both personal and work calls, there wasn’t money budgeted for a phone for the nurse. Staff indicated that the Finance Team told them to hold their request for a new phone until the end of June. (There was also mention of the budget exercise.)*

Woodford stressed that the current situation is very different from past years. Much of Amico’s work depends on communicating with the public. Member Dan O’Rourke said he thought the reason they signed off on a State of Emergency was for needed funding.

There was reference to possible funding through the Board’s Revolving fund for vaccines and emergencies. Administrative Asst. Barbara Spiri warned that the amount in the fund had been lowered by the department’s need to purchase a fridge. They did recently get a vaccine reimbursement. Chamberlin reminded that the up-front cost for purchasing high dose flu vaccines for the fall clinic is high and reimbursements can be slow. 

In context of following the Town’s directives on the budget, Public Health Director Pisinski reminded the Board that they were independently elected. He said they were only required to “coordinate” with the chief executive and voters have been supportive of public health.

Woodford moved to approve purchasing a phone to be reimbursed and, if necessary, a laptop. The Board agreed.

Earlier, Pisinski gave thanks to IT Manager Tom Laflamme for switching over his laptop to Amica. Woodford was concerned about the impact of a slow computer on Amica’s workload.  Laflamme clarified that the laptop Amico just received was only a year old. She confirmed that while she had just gotten setup on it the night prior, it appeared to be fine. 

Laflamme confirmed that if his budget passes at Town Meeting, a new laptop would be prioritized for the dept in July. In the meantime, he didn’t seem to think a new one was required for Pisinski. Woodford said the “if necessary” vote was to allow Laflamme, Amica and Pisinski to determine if something more is needed.

Staff burden

When the Board hired Amico in March her position was listed as 15 hours. Since taking over the job in mid-April, she has been working closer to 40 hrs/wk.

Amico asked the Board if they had a plan for how to handle her hours going forward. The Board will address that at next month’s meeting. By then, Woodford hopes that Amico will have a better idea of what her workload will look like heading into the summer.

Spiri noted that the department could only increase Amico’s hours to 4o for up to 90 days. After that, they would have to create a new full time position. 

Amico hoped she was on track to lower her hours to 30. She had started being able to delegate more of the quarantine follow up to Southborough School nurse. Former Public Health Nurse Leslie Chamberlin asked if the nurses are paid to work year round or only until June. No one knew.

Asked her ideal situation going forward, Amico seemed unsure. She said she had thought that a combined 30 hours through her two part-time jobs was ideal. Because she couldn’t handle more than 40 hours with her home situation, she hadn’t worked for Sudbury the past three weeks. Since she wanted to retain oversight control of Southborough’s situation, she was uncomfortable with the suggestion that she might want to cap hours at 20/week.

Woodford pointed Amico to look into possibly using the state appointed Contact Tracing Collaborative to help. She said that Framingham (which has much higher numbers) had started using the CTC on a small number of cases.

The Chair said a plus was that CTC staff includes people who speak different languages. But she also indicated that the Framingham nurse was trying to vet how diligent CTC was before delegating more to them. She said they’d get a better indication in the next few weeks. It would be a no cost option.

Public Health Director Paul Pisinski agreed that they should talk more at the next meeting. He noted that even 30 hours was a full time, benefited position. If the Board wanted to pursue that, it would require going to the Personnel Board and then Town Meeting.  

Amico pointed out that under the State of Emergency, FEMA is reimbursing for 75% of her extra hours. If the position was rewritten to increase her hours, those hours wouldn’t be reimbursable.

Chamberlin has been working for the Senior Center. She indicated that he has been and would continue to be able to give some of that time to support public health.

*The “exercise” is asking departments to cut budgets lower than their pre-pandemic budget requests. Selectmen plan to look at what it would take to avoid a tax increase this year or cap it at a 2% increase.

{ 7 comments… read them below or add one }

1 David P Gould May 12, 2020 at 5:11 PM

Money vs.health-money seems to be winning-WAKE-UP people-find the money-It is the people of Southborugh you are letting down!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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2 arborist May 12, 2020 at 8:18 PM

I can’t believe what I just read, This is a pandemic, give the board of health the tools they need to do their job! Cut somewhere else, Like invasive plant control and Ball field lighting just to name two.

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3 southsider May 13, 2020 at 9:00 AM

“In context of following the Town’s directives on the budget..” .. I think the town managers are trying to either miselad or bully the department heads/chairs with their communications and I’m glad to read that Director Pisinski called it out. I don’t think these managers can “direct” the submitted budget of this or any board. I’m pretty sure that the way it works is that we elect or appount these department and commission heads to create a budget to be submitted to Town Meeting where the citizens then have a chance to vote on it. Town managers, BOS and Advisory can all warn that they may take an opposing position at TM but those boards and commissions should still go forward with what they think is right and likely to be approved at TM. None of us want them wasting time and effort chasing budgets that have no chance but disagreements over relatively immaterial amounts shouldn’t all be resolved by “directives” from the town managers. let us decide.

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4 beth May 13, 2020 at 9:42 AM

Some more context –

1. In one of this spring’s virtual meetings earlier this spring, selectmen and the Finance Team agreed that departments would be asked to put freezes on some of their expenses this year. (I was surprised to see that I somehow didn’t include that detail in any of my posts – at least that I can find. The discussion was part of the financial impacts of the pandemic and reduced revenue.)

2. Selectmen got a briefing from the Health dept on March 24th and asked if there was any additional support needed. These issues weren’t raised at that time – which predated the start of the new nurse.

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5 Claire Reynolds May 13, 2020 at 12:46 PM

Now is NOT the time to cut the Board of Health budget !

Keep in mind that the 2021 budget starts July 1 (less than 2 months away) and there is no evidence that COVID-19 is going away in the coming fiscal year. The Board of Health should be given everything that they feel is necessary to proactively do their job.

While I certainly support budget cuts (especially now with taxpayers out of work), I know there are budget cuts that can be made elsewhere. (As a former Advisory Committee member, I know how to dig into expenses.)

Let’s make sure that we are being responsible to taxpayers and providing the services that they NEED.
Thank you
cc: Board of Selectmen, Advisory Committee, Finance Committee

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6 David P Gould May 13, 2020 at 1:26 PM

Comments with ideas on the right thing to do-funding the tools to do the job-Protect the people of Southborough and their health!!!!!

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7 RN May 13, 2020 at 4:10 PM

I am in complete agreement with Claire Reynolds. The school nurses of Southborough would be a great addition to the BOH during this time. School nurses in other districts are assisting the BOH in tracking cases of Covid-19 among other duties. Since the nurses are not working in the schools at this time their expertise could be utilized at the BOH.

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