Health Department Lay-offs & the Board of Health

Effective February 27, the Mayor laid off both direct service employees in Amesbury's Health Department--Health Agent and Public Health Nurse--as part of 18 positions eliminated to re-balance the current year's budget. As has been reported in local newspapers, this action has caused some concern among residents and members of the Board of Health.

I have talked with BOH members, members of the community, and MA Dept. of Public Health officials about this situation. Whether from the newspaper reporting, the BOH's meeting earlier this month (3/5) or the Mayor's own statements, I think there has been some basic information, perspective and analysis missing. At the 3/5 BOH meeting, I only heard one Board member really talk through the actual BOH responsibilities.

Here's my own take in a nutshell, based on the information that I've gathered:

The Board of Health's responsibilities are broad and it is the Town's responsibility to give it the resources it need to meet them. In my opinion, most of those responsibilities can be met by contracting for services rather than employing permanent staff. Responsibility for giving the BOH the tools it needs lies with the Mayor to design, the Council to fund and the BOH to approve.

This issue has rightly been a matter for the Mayor (as chief executive) and the Board of Health (as the responsible party) to work out together what is the most cost-effective way for Amesbury to meet this obligations and protect the public health of Amesbury's residents. Ultimately, the BOH is 'on the line' for maintaining public health in Amesbury, and they will decide that they do (or don't) have the tools they need from the Mayor and the Council to do their job.

For me, the key to this entire discussion is answering the basic question: what are the responsibilities of the Board of Health?

Local Boards of Health are empowered by Massachusetts law to oversee important elements of public health on the local level. CLICK HERE to read an overview of local BOH duties. Almost all of the BOH's duties are inspectional in nature: Sanitary Code enforcement for dwellings and restaurants, enforcement of Title V code for spectic systems, garbage/trash disposal, pool/beach water quality sampling, camps/mobile home park licensing, smoking/public space restrictions. These are the services that I think lend themselves to be purchased by the Town on an as-needed basis (contract) from professionals.

A tougher question is about having a public health nurse. Health care and disease control responsibilities include receiving and transferring reports of communicable diseases, as well as providing for anti-rabies vaccination and other vaccinations if necessary in the opinion of the BOH. These responsibilities are specific and limited. They do not extend to the provision of any direct health care. According to a 3/21 Newburyport Daily News article on this issue, the public health nurse's responsibilities have included "health screenings, blood pressure checks [and] medication reviews."

While I do not question at all the general value of such services, especially for Amesbury's older or low-income citizens, I do question if it is part of municipal government's role to provide health care (beyond disease surveillance and basic vaccinations). I work in the field of health care and services for very low income households, so I definitely get the important role of community-based health care and referral services in supporting public health. Based on the information that I've received from the MA Department of Public Health, however, I'm not sure I see a big role for the Town in actually providing health care services.

My concern is that we are mixing what we must do with what we can also do in terms of public health. We must make sure that we comply with MA general law's public health provisions. We may also make policy decisions to provide additional care or support to the community. (An example, we must provide basic levels of policing; we may also pay to have force members specially trained to focus on domestic violence in our community. We must keep our library doors open a certain number of hours a week; we may provide literacy classes at the library at taxpayer expense.)

For the moment, this issue is in the hands of the Mayor and the BOH to work out, in the context of the Mayor's recent cuts. It will come before the Council soon, however, as part of the 2010 budget. That budget will contain monies to pay for Amesbury's public health needs. At that point, the Council will have a role in this issue. I will have plenty of questions for both the Mayor AND the BOH, as part of the budget process, centered on the thoughts and concerns above.

In the end, there are two questions two answer. First, what are the basic responsibilities of the BOH and what tools does it need to achieve them? Second, are there additional services and objectives above and beyond those basics that the Town and BOH would like to have in place? Only after the first question is answered should we even begin to discuss the second question. I think that the two questions have been mixed together in the discussions to date, however.

Amesbury & Governor Patrick's Plan for the Federal Stimulus $$

Earlier this month, a Gubernatorial Task Force released a report on how the Commonwealth should spend Federal Stimulus monies. CLICK HERE to go to the Task Force's website.

CLICK HERE to read the Task Force's report. The Report looks at (primarily capital) spending in these areas:
a) Energy
b) Education Facilities
c) Transportation
d) Information Technology (including electronic medical records)
e) Private Development (including broadband expansion)
f) State Facilities and Courts
g) Municipal Facilities

You may have heard about communities submitting lists of 'shovel-ready' projects to the Commonwealth. You can read a list of projects that the Task Force and its Working Groups deemed 'shovel-ready' by CLICKING HERE. As I read the report, listed projects are prime candidates for receiving funds made available by the federal Recovery Act. That does NOT mean that Massachusetts will in fact receive monies to cover the $9,589,367,163 worth of projects listed.

Where does Amesbury fit it in this? A word search of this 78 page list shows that one Amesbury project made it on to this list: $2,439,045 for the planned Transportation Center in the Lower Millyard. This project is in fact an important one to Amesbury and one of the 2 keys to the redevelopment of the Lower Millyard (the 2nd is the relocation of the Department of Public Works building).

The Task Force actually received many more projects for review from municipalities around Massachusetts. CLICK HERE to read a list of received projects that did NOT make it on to the list. Amesbury actually submitted 33 projects to the Task Force for review, including monies for road, drain and sidewalk upgrades, and other projects. Though I had not seen news of it in the local press, I was pleased to see that Amesbury had submitted projects worth tens of millions for review (we have extensive infrastructure needs, to say the least).

The projects listed in this report are all capital projects, meaning infrastructure investments. I believe that the Recovery Act may also have monies for other purposes, such as public safety and education, so hopefully we will have opportunities for other monies as the come down in coming months. The Transportation Center was already funded through the Commonwealth's Transportation bond bill, so it looks like Amesbury doesn't stand to pick up new projects; this looks more like the Commonwealth may use Stimulus $$ to replace Commonwealth $$ for this particular project. Stay tuned!!

2/09 Staff Reduction Plan

Mayor Kezer announced final lay-offs on Friday 2/13.

CLICK HERE to read the Mayor's Press Release.

CLICK HERE to read the list of eliminated positions.

These cuts are painful and involve the lay-off of dedicated public servants. These reductions are in response to: mid-year FY09 cut to local aid last month, low revenues from excise tax and investment/interest income and severe reductions in local aid for FY10. We know that Amesbury can expect at least a 30% reduction in local aid for Fiscal Year 2010 and these staff reductions should give us a good lead on that (the fiscal year starts July 1; see previous post). Better to re-shape municipal services and make these reductions now then handle them piece-meal. Amesbury is caught in the same fiscal tsunami facing states and municipalities across the country.

Looking ahead as we start FY10 budget preparation, I see continued tightening of spending and the reduction of municipal services. I don't see any improvement from the Commonwealth for quite a long while, meaning the pressure on local revenue (e.g. property and excise taxes) will be all the greater. Amesbury's households, however, are also under great pressure - layoffs, adjustable mortgages kicking in, reductions in home value and retirement savings - so there is no room for increasing revenue locally, either. It all adds up to hard choices about what services we can eliminate and still keep a basic level of services. We will face those choices in developing next year's budget.

ADDT'L COMMENT, 2/22/09: I've had a number of questions about the layoffs and the current 'state' of Amesbury. As I understand it, these lay offs were NOT made simply to balance the remainder of the FY09 budget (that goes through the end of June, 2009).

As I posted above, Amesbury is facing a HUGE reduction in local aid from the Commonwealth, starting in July. From the Mayor's comments at the last Municipal Council meeting, the press release announcing the cuts and conversations with the Mayor and his Chief of Staff Kendra Amaral, it is my understanding that these lay offs are intended to absorb the FY10 cut in local aid in advance. Running 'back of the envelope' numbers about what the 19 positions might save, estimating $50K annually in salary + long-term benefits over the remaining 4 months of the year plus ALL of next fiscal year, I put the savings at about $1.2 million. Given the $250K local aid cut from this year's budget + expected $700K cut in local aid from next year's budget (July 1), then it looks like these cuts are intended to and will largely close the budget shortfall created by the deep local aid cuts.

I think taking action NOW in a decisive manner to get ahead of coming reductions in revenue is very prudent and I support the Mayor with taking quick action. I've had folks ask why they haven't seen other local communities announcing lay offs like this. All I can say is that EVERY community is getting the same cuts to local aid and all I can say is that the longer they wait to make cuts, the deeper their cuts will have to be.

As a Municipal Councilor, I have additional questions about the cuts and look forward to hearing more about their rationale. Particularly, the elimination of the public health staff and the elimination of the Permit Coordinator position concern me. There are no good choices to make at this juncture---every cut will mean a reduction in basic services, no way around it. Conversations about what are core services to focus on as our revenues tighten up will be important, especially as we develop the FY10 budget over the next months. I will be asking for more information about these cuts and our overall situation; please me know what your questions and concerns are about these developments.

Mayor Kezer's Budget Memo to Council - 2/10/09

CLICK HERE to read a copy of the memo that the Mayor presented to the Council last night regarding planned cuts to the FY09 and FY10 operating budgets. My own comments to follow soon.

Gov. Patrick's FY10 Budget Cuts $698K from Amesbury's Local Aid

We are heading into budget season on the State and Local level. The Governor's proposed 'House 1' budget includes a substantial cut to local aid for all MA municipalities. Amesbury's share of this is $691,232. For perspective, our FY09 local aid share in Amesbury was only $2.4 million, so this represents a 29% decrease in local aid. It is hard to over-emphasize the negative effect that this will have on Amesbury's operations. CLICK HERE to view the Governor's memo to Amesbury regarding our proposed FY10 local aid amounts.

This comes on top of the recent $250K+ mid-year FY09 cut to local aid that we received in January. And on top of substantial drops in excise tax receipts, building permits and interest income (from Town investments and savings accounts). And on top of a very expensive winter storm season. And on top of rapidly increasing veteran's benefits (paid out by the Town).

Amesbury is caught in the same financial storm that virtually every community and State in the country are facing. There is absolutely no way that Amesbury will be able to avoid making the same kinds of cuts that governments and businesses everywhere are making. When personnel represents that vast majority of our operating costs, then we have no option but to cut positions. This situation will be long-lasting and extend beyond the recent announced cuts to local aid, I have no doubt. Mayor Kezer will be announcing lay-offs and other budget reductions soon that will not be temporary changes but rather, long-lasting.

In his remarks to the Municipal Council at last night's meeting (2/10/09), he described an approach that will not merely take a % decrease amount and spread it evenly across departments but rather is re-examining all services provided by the Town and will focus on preserving core services and reducing or eliminating other services. While arguably all of the current services that the Town provides could be considered 'basic' and essential, some--such as education and water treatment--are 'more essential' than others, say, composting leaves. We will all have to reckon with calculation. I look forward to hearing specifics from the Mayor soon for the balance of FY09 cuts (through June) and how those will extend through next year (FY10).

December Mayor's Report & Local Aid Cut

CLICK HERE to read the Mayor's December 2008 report to the Council and Department Heads. The report details the hours and costs associated with the December ice storm and the other snow storms to date. As happens some years, these costs will exceed the amount that we budgeted for snow and ice storms. This December, our DPW hours spent simply exploded.

This could not come at a worse time. As the memo also mentions, state and local revenues are down from budgeted predictions and Governor Patrick announced cuts to local aid just last Friday, at the MA Municipal Association Annual Meeting. He is cutting 9.74% off of local aid (not including Chapter 70 school aid). Amesbury receives $3,656,349 in non-school local aid, meaning Amesbury will have to cut $356,128 out of the remaining 5 months of our FY09 operating budget (as I calculate it).

In anticipation of both this fiscal perfect storm, the Mayor announced a general spending freeze. Read his memo HERE.

Split Tax Vote

At the December 9th Municipal Council Meeting, we decided to set the property tax rate for residential and commercial, industrial and personal(CIP) property at the same rate of $16.53 per $1,000 of assessed value. For the two years prior, the tax rate had been split, with residential rates below the rates for the CIP class, which were set at a factor of 1.15. This means that in 2008, residential tax payers paid $14.60 per $1,000 and CIP paid a rate of $17.20 per $1,000 (about 18% higher). In 2007, it was $13.16/residential and $15.47/CIP.

I opposed the split when it was enacted in 2006. As a residential taxpayer, I understand the appeal of the split--lower tax bills for homeowners. But this is won at the direct expense of the CIP property classes. Each December, we set the tax rate in order to raise the revenue needed to fund the annual budget approved the previous summer. The CIP class only represents about 14% of our total property tax base and the number of parcels has been shrinking of the past years. So, raising the rate on this class is like trying to squeeze a shrinking lemon.

What drives your tax bill and my tax bill is not the rate but the budget. The rate is just a function of the amount of money that needs to be raised as revenue. Splitting the tax provides the illusion of lowering taxes but not the reality of it.

I've looked at a lot of data from the Assessor's office and the MA Dept. of Revenue and have talked about this issue with many constituents, the overwhelming majority of whom wanted to return to a single tax rate. When it came to setting the rate, we had the option of keeping it, widening the split, reducing the split or getting rid of it completely. In the end, we decided that it was best to simplify the process and return the rate to single rate all at once.

For reference, over the years 2000-2009, we have had 4 years with higher rates and 5 years with lower rates. From 1990-2009, we have had 11 years with higher rates and 8 with lower rates. CLICK HERE to see some comparative information. As you can see from this chart, as property values rise, rates drop and as values drop, rates rise. We are in a period with a strong decline in values, so our rate went up accordingly. You can also see that our average residential tax bill is slightly above the state average but follows it very closely from 1990 to now.