Town of Provincetown
FY 2022 Budget
Division 3: Public Safety
253 Health Division
Under M.G.L Chapter 111, the Board of Health and Health Department manage the public and environmental health and welfare of Provincetown by protecting the food and water supply; inspecting housing; protecting environmental health and sanitation through wastewater and stormwater management; performing communicable disease surveillance and management; planning and preparing for emergencies; promoting community health and well-being; licensing and regulating Provincetown’s core industries of food service, body art, lodging, and solid waste; managing public solid waste and hazardous waste collection along with the Department of Public Works; monitoring beach water quality; and investigating general nuisance conditions. Many of these activities are required under State Law to assure population health, well-being, and sanitation of the community.
The Health Department serves Town residents, businesses, and visitors in a variety of ways that protect public and environmental health. The Department continues to expand its capacity while always seeking to do so with a limited impact on the Town’s operating budget. The Health Department’s budget is historically well funded by its fees and fines (FY2020 revenue was $196,436). This year, the Department is requesting additional funding for mental health services, however the goal is that the mental health programming can be supported through marijuana tax revenue. The Health Director’s salary is partially supplemented by the Wastewater Enterprise Fund.
Major Accomplishments for 2020
- Researched and wrote recommendations that became the Joint Order of the Select Board and Board of Health.
- Developed a local dashboard of metrics to monitor stress on local infrastructure.
- Researched and wrote industry guidance while the state’s guidance was being drafted.
- Communicated local and state regulatory guidance and advisories with licensees and the general public via email distribution lists, webpages, press releases.
- Researched and presented online training to licensees, including licensees of other departments, prior to COVID Re-Opening in anticipation of safety standards to review state guidelines.
- Initiated and ran regular calls with local health and human service providers and the faith community to ensure that gaps and needs that arose during the pandemic were met and addressed.
- Initiated and ran regular calls with front line representatives to ensure that communication channels were open, questions were answered, and concerns for future were considered.
- Provide regular community updates on the pandemic; through call-in Q&A sessions and reports at Select Board and Board of Health meetings.
- Write and distribute a Weekly COVID-19 Update using alert system.
- Accommodated all pre-application meeting, plan review, and other Health Department guidance requests, both pre-pandemic and after the Emergency Order via online platforms.
- Continued to check wastewater design flows at every stage of Health Department review and make corrections where needed.
- Guided 24 new and potential food establishments through plan review to ensure compliance with federal, state, and local health regulations.
- All six licensed refuse haulers complied with the BOH regulation1023 ‘Provision of data to the Board of Health’ for 2020 license renewal, providing tonnage of refuse and recycling collected.
- All semi-public pool operators provided updated Virginia Graeme Baker certification in 2020, most operators installed with new, compliant drain covers.
- The Board of Health met frequently during the pandemic via online platforms.
- Health moved online applications to a new software application starting June 1, 2020, with the goal of a higher level of online applications.
Ongoing public health programming and initiatives include:
- Winter Wednesdays: free programming to encourage community engagement in the coldest and darkest months of the year. A joint program with the Provincetown Public Library, Housing/Economic Development Department, Wellfleet Health Department, and the Provincetown and Truro Schools.
- Crystal Free: a weekly drop-in group for men seeking freedom from crystal meth use, offered by the AIDS Support Group of Cape Cod.
- Community Support Liaison program: providing case management services for previously unserved populations, offered by Homeless Prevention Council.
- Yoga for Addiction Recovery: a weekly yoga class for people with substance use disorder and those who love them. A joint program with the Recreation Department.
- Crop Swap, the community’s produce swap shop launched in September 2018, in partnership with the Provincetown Public Library, Soup Kitchen in Provincetown (SKIP), and the Friends of the Provincetown Library. Since its inception, the Crop Swap has given away 3.5 tons of fresh produce to the community.
Public Health Communications
- Continued social media presence on Facebook and Instagram, posting relevant health and wellness related information. Followers have increased significantly in the past year. As of 11/18/20, the Provincetown Health Department’s Facebook page has 507 likes and 621 follows, quadruple the number from this time last year, and Instagram has 227 followers.
- There are almost 4,000 people signed up for the Town’s alert system, which is double the number of participants in the previous alert system.
FY 2022 Objectives
- Guide the community through the pandemic using science and evidence-based interventions until a safe and effective vaccine is available to all.
- Continue to address the mental health challenges of the pandemic in concert with other community agencies and the faith community.
- Build a mental health component to the Health Department’s work to address gaps in the existing mental health field through contracts and grants.
- Strengthen community connectedness, health, and well-being by offering public health and wellness events and programming in connection with community partners and guided by stakeholder input.
- Effectively communicate public health information and initiatives to the greater public.
- Continue to partner with our local businesses on state and local guidelines for safer practices during the pandemic.
- Continue to streamline processes to improve efficiencies and support economic growth.
- Protect environmental and public health in Provincetown, using up-to-date Board of Health regulations and public educational campaigns.
- Manage existing wastewater assets, including septic and sewer systems, to protect the health and environment while supporting managed growth.
- Plan for strategic expansion of the sewer to ensure optimal environmental safety and public health protection.
Performance / Workload Indicators
FY 2022 Additional Budget Requested
Additional Amount Requested: $ 60,500
Budget Line: (01253200 570050)
One Time Only or Ongoing Expense? Most are ongoing, according to a 5-Year Plan. See information below for more details.
Description of Additional Program, Product or Service: Requesting additional funds to support a package of programs to address mental health/substance use disorder gaps in service in Provincetown. Requesting funds from marijuana tax revenue. See descriptions of programs below for more detail. Requested funds are for Year 1 of 5-Year Plan.
Cost/Benefit Analysis: The Town has been aware of the gaps in services for mental health and substance use disorder, and has sought to address those gaps incrementally. The COVID-19 pandemic is accompanied by a mental health and substance use disorder epidemic, the likes of which communities have never seen before. Gaps have become fissures and a more comprehensive approach is required. Additionally, the Town is beginning to realize revenues from the sale of recreational marijuana. The Health Department is requesting marijuana tax revenue to apply to comprehensive mental health and substance use disorder programming.
Program descriptions (Year 1 of 5-Year Plan):
Build and maintain an up-to-date website as a resource for locating mental health and substance use disorder services on the Outer Cape.
$13,000 ($10,000 - web design/hosting; $3,000 - photo shoots for images)
One time, though may have smaller maintenance fees moving forward.
Details: Contract with a company to design and build a website to serve as a resource for people looking for mental health and substance use disorder services.
Increase public health budget for mental health / wellness community groups.
$20,000 (2 groups at $10,000 per group)
Details: Topics for groups will be determined through provider and stakeholder input. Examples of group topics may include ongoing recovery, mindfulness in trying situations, hoarding, etc. Groups will be held in town spaces.
Provide funds for residents who want to attend therapy, groups, or other mental health/substance use disorder services, but encounter barriers to do so (including childcare, transportation, and other barriers).
Ongoing, would reassess amount yearly.
Details: Funds will be provided through the Community Support Liaison program, which works with community members who are struggling with mental health/substance use disorder. Any Provincetown resident who is in or seeking treatment but encounters barrier to accessing the treatment would be eligible for the funds. Examples include childcare, transportation, internet access for telehealth, etc.
Provide grants to local youth (25 and under) to attend classes, camps, or to arrange for transportation to classes and camps (Iceland model).
Details: Provide grants to youth under the age of 25 who live in Provincetown to enable them to attend classes and camps or pay for transportation to classes and camps. This is using Iceland's model of eliminating any barriers to youth engagement in activities, to decrease youth substance use rates.