Division 3: 253 Health Division

Town of Provincetown

FY 2024 Budget

Division 3: Public Safety

253 Health Division

Personnel Expenditures

Operating Expenditures

Budget History

530000: Contracted/Professional Services

This line supports the Department's contracted services, including the Homeless Prevention Council Case Management 'Community Support Liaison' program, contracted environmental health professionals, rodent abatement, and the Board of Health secretary for taking meeting minutes.

570050: Public Health Expenses

This budget supports legacy programs (sharps collection, well child visits, lactation support), substance use disorder programming (Crystal Free and Yoga for Addiction Recovery), food insecurity programming( Crop Swap) and community connection (Winter Wednesdays). This line advances public health work guided by 2015 and 2022 public health needs assessments (the barriers elimination and youth activity funds administered by HPC), and funds Buried in Treasures and hoarding recovery coaching. The increase includes boosting the allocation to the BIT program and proposes to contract Outer Cape Health Services Navigator for community health support services, and contribute to regional teen activities. This new program launched fall, 2022 with a grant through Outer Cape Community Solutions, to ensure continuation. The Navigator and teen programs propose matching Outer Cape Health Departments budget shares for regional services.

In Barnstable County regional ‘Public Health Excellence’ workshops Health Departments are preparing for the MA DPH expectation that critical inspections are performed using software that the agency can access. These are packages built by subject matter experts based on the field work of food establishment and sanitary inspections, and automatically updated when the codes are revised (as is expected with 105 CMR 410 for housing in 2023). Inspections included searchable database to citations ensuring standard language and can be customized for local provisions. Results are PDF forms that can be issued to the licensee or housing tenant/owners and attached to the ViewPoint record. Moving to electronic inspections modernizes Health Department operations and results in cleaner, more easily retrievable records. In order to support this new budget request, I have made a modest reduction to the promotion budget.

Program Description

Under M.G.L Chapter 111, the Board of Health and Health Department manage the public health and environmental sanitary codes for the welfare of Provincetown by protecting the food and water supply; inspecting housing; contributing to wastewater and stormwater management; coordinating communicable disease surveillance and management; preparing for emergencies; promoting community health and well-being; licensing and regulating Provincetown’s core industries of food service, lodging, body art and solid waste; managing public solid waste and hazardous waste collection along with the Department of Public Works; monitoring beach water quality through the services of Barnstable County Department of Health and the Environment; 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.

Budget Statement

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 and increase efficiency, seeking to do so with a limited impact on the Town’s operating budget. The Health Department’s budget historically is well funded by its fees. The Health Director’s salary is partially supplemented by the Wastewater Enterprise Fund.

FY 2024 Objectives

Public Health:

- Continue to guide the community through infectious disease risk assessment (COVID-19, MPV) with evidence-based information and public education outreach efforts.

- Strengthen community health and well-being by planning events and building programs in collaboration with non-profit/NGO partners and other local or regional health agencies. As an example of the Outer Cape Regional Health Departments sharing services, the Winter Wednesdays program has been expanded through a Cape Cod Healthcare grant to address various social determinants of health, allowing community members from all four towns to create connections and combat social isolation. The Health Departments may extend our existing MOU for shared services to pool resources under the Opioid Abatement Funds resulting from the 2021 Massachusetts Attorney General resolution with opioid distributors. This is an agreement to use eighteen (18) payments over the next seventeen (17) years payments to abate the opioid crisis in our communities for prevention, harm reduction, treatment, and recovery programming.

- The Provincetown Health Department hosted several COVID booster and a flu vaccination clinic with the Barnstable County Public Health Nursing program, and intends to continue with annual fall clinics. The Health Agent distributed 8,970 free COVID-19 rapid tests in 2022 to residents, businesses and anyone needing supplies, including about 900 to participants at each, the annual and the special Town Meetings, almost 200 to Year-Rounder Fest and about 300 for the summer Recreation Department programs. The Health Agent will continue to support community needs, sharing the information that insurance companies are required to reimburse up to 8 tests/ month. Antigen test kits are now readily available in retail pharmacies - a vast improvement of conditions during the surge of Omicron variant at the start of 2022.

Licensing/Regulatory:

- Continue to streamline processes, improve efficiencies and support economic growth. Online permitting has significantly reduced staff hours required for annual licensing renewals and the Barnstable County Health Agents Coalition is investigating inspection software to further modernize operations. The Health Agent plans to participate in food and housing platform trials and regional "training hub" opportunities.

- Protect environmental and public health in Provincetown, using up-to-date Board of Health regulations, public educational campaigns and plan review to secure facility upgrades.

- After two years of social distancing and COVID-related restrictions from hosting in-person events, the Provincetown Health Department sponsored the following trainings in 2022 for the food service industry: six sessions of Choke Saver with the Cape Cod Medical Reserve Corps, two sessions of "FOG Training" (fats, oils and grease best management practices) with AECOM and the DPW, and six sessions of ServSafe certified food protection manager training with the Cape Cod Cooperative Extension Service. The Health Agent plans to continue providing these resources to the restaurant sector and plans to build a food service-specific Health Department curated webpage posting links and resources essential to safe and sanitary operations.

Environmental Health/Wastewater:

- Support the Phase 6 wastewater treatment system expansion plans to protect the health and environment while reviewing managed growth. Manage existing wastewater assets, including septic and sewer systems, streamline Administrative Consent Order (ACO) process and develop Title 5 Septic Inspection tracking program.

- Title 5 Inspections are reviewed for appropriate design flow and proper function of on-site septic systems. ACOs offer as a means for the property owner to commit to connecting to the sewer when available and not having to upgrade, by maintaining safe and sanitary wastewater disposal under permitted repairs and/or a prescribed frequency of inspections.

- Follow up on Special Town Meeting's approval of the sewer expansion and modernization plan with applicable updated to local Board of Health Regulations.