Lee, Lenox, and Stockbridge — Tri-Town Boards of Health (Tri-Town) members sought answers at their April 9 meeting, a response as to what coordinated role the agency would play in the face of a public health disaster and the plans to be implemented to safeguard residents of the Berkshire community.
The group, which represents the boards of health of Lee, Lenox, and Stockbridge, invited Berkshire County Boards of Health Association (BCBOHA) Director Laura Kittross to respond.
At the end of the session, one thing was certain: The dais made its point.
The hierarchy of emergency preparedness in a nutshell (and a lot of acronyms)
The Centers for Disease Control and Prevention (CDC) funds public health emergency preparedness through the Massachusetts Department of Public Health (MDPH) that, in turn, distributes the money to regions, including Berkshire County’s Region 1 Emergency Preparedness Region.
The BCBOHA is the emergency preparedness coalition for 32 local boards of health in Berkshire County, including Tri-Town. It is also known as the Berkshire County Public Health Emergency Preparedness Coalition (PHEP). Berkshire Regional Planning Commission (BRPC) staffs the BCBOHA and acts as its fiscal agent, or host, for emergency preparedness funds. Public health emergencies in this program can range from a local measles outbreak and the spread of bird flu to exposure from anthrax.
The PHEP, or BCBOHA, began distributing grants to local boards of health in the early 2000s, first for equipment to be used in an emergency and, later, to create more complex emergency operations plans that contain communication, volunteer recruitment, and mutual aid measures. The BRPC website states the BCBOHA is tasked with helping local boards of health, with emergency planning, and by offering “step-by-step templates” to guide those boards through the planning process,” hiring emergency planners and by having regional emergency plans on preparedness.
The issue
The BCBOHA has a seven-member executive committee that meets monthly.
For Tri-Town, the recent issue stems from an email sent out by the BCBOHA asking the boards of health to create an “emergency preparedness framework.” That framework, according to the April 16 BCBOHA Executive Committee agenda, is due next month.
Tri-Town Executive Director Jim Wilusz said he was “confused” as the plans he found were outdated, seemed to rely on a regional response, or even split up the three towns that comprise the Tri-Town Boards of Health. He reached out to different local government agencies—police and fire departments, Select Boards—to see what response those officials had. “Everyone was as confused, if not more confused than I was on where we are,” Wilusz said. “We’re trying to get an understanding on what role Tri-Town Health plays in emergency preparedness planning.”
Kittross said, this year, the state directed that each town must produce its own protocol, or plan, for emergencies, and the BCBOHA offered workshops on such framework development.
However, Tri-Town Chair Charles Kenny pushed Kittross for accountability for the large sums of money received by the BCBOHA over the years that should have been dedicated to developing emergency plans, noting those plans don’t seem to be up to date or readily available. “I think you received [$250,000] last year to do emergency-management preparedness and to coordinate that with the different towns,” he said to Kittross. “So, what we’re asking you very simply is, considering the fact that you received millions of dollars to do this for 20 years, ‘What is the role of the Tri-Town Health Department in the current emergency-management plan?’”
Acknowledging the involvement of obvious first responders such as fire and police in an emergency, Kenny pressed for evidence of a preparedness plan that coordinated those and other departments. According to Kittross, the BCBOHA has a variety of emergency plans available, for towns and regionally. “A plan is only a plan,” she said. “A plan is not a blueprint of ‘you’re going to exactly do this.’ A plan is what allows us to think ahead of time so we’re not reacting in the moment.”
Kittross answered that Tri-Town’s role is “whatever Tri-Town has the time, the capacity and the ability to do at the time of the emergency.” Due to the group being one of the larger health departments in the area with a capable and certified full-time staff, she said Tri-Town “will always be part of a leader in any emergency” but no individual member “is going to be assigned a role that they have to fulfill in the case of an emergency,” since some members may be away during a disaster.
Tri-Town Board member Robert Wespiser drilled down for specifics, asking Kittross to cite examples of plans in existence. “Is there a plan available for a terrible, devastating hurricane?” he asked. “Is that framework usable in that setting? There would be some public health factors within that, whether it was people’s medication or the ability to have sewer and water. Is there a plan, at least roughly outlined?”
Those types of natural disaster plans fall under what most towns list as their hazard-mitigation plans, Kittross explained, but her agency has crafted pandemic, family reunification, regional sheltering, mass fatality, and joint information/risk communication plans that share details on emergencies.
Asking Kittross for her agency “to take a more active role in individual towns planning for [emergencies],” Lee Select Board member Robert “Bob” Jones said he doesn’t understand how the BRPC funding for the past two-plus decades “actually translates into service to the towns.”
Stockbridge Select Board member Patrick White voiced concern over procedures that should be communicated to the public in a shelter-in-place situation or if an accident occurs with vehicles transporting toxic materials on the Turnpike or using Berkshire roads.
Kittross said she hoped her office would be consulted on White’s examples; however, the group wouldn’t take the lead on the response. Although a web-based program exists to address emergency operations, participants said access wasn’t available.
For Wespiser, moving forward with emergency preparedness means first knowing the plans exist and then reviewing or updating those plans, with an eye toward better involvement and input from key players.
“From the perspective of a long-standing board of health member who’s a volunteer, I would be interested in having confidence that at least outlines of plans for various scenarios exist, that the right people are listed in this framework and database, and there was opportunity to understand significant updates to those plans so I could factor in how my role as a board of health member would play into those,” Wespiser said.
Funding trail
Kenny questioned Kittross on how the Executive Committee spends its funds. Although the committee posts meeting notices and agendas and provides for remote access, it doesn’t record sessions, a sticking point for Tri-Town members. Kenny asked for the sessions to “be more transparent.”
“Do you simply make this decision unilaterally,” he asked Kittross. “It seems to me that the funding is supposed to be for the towns with BRPC facilitating the funding going to the towns based on their needs for this emergency-management preparedness.”
The BCBOHA Executive Committee is voted on by the membership in the fall, with the Tri-Town dais counted among the agency’s membership, Kittross said.
Kenny ended the discussion noting that members and Kittross, although in agreement, were still left with “confusion … a lack of communication, that we don’t understand what’s going on completely and that needs to be changed.”
“All we want to do is have an emergency-management plan that everybody feels confident with, that doesn’t give us contact numbers from people who aren’t here anymore,” he said. “So I would encourage you to, at next week’s … meeting, have [the April 16 Executive Committee meeting] recorded and put it on [Community Television for the Southern Berkshires] so we can all see it, so we can begin to work together to change the confusion, to change the lack of communication, and to do a good job for our communities and have a well-coordinated emergency-management plan that involves the boards of health and the fire and police.”
