Carlisle’s Board of Health does “the business of the town”

by Priscilla Stevens

The Board of Health includes: (seated, left to right) Donna Margolies, Chair Bill Risso and Cathy Galligan. Standing are (left to right) Todd Thorsten, Health Agent Linda Fantasia and Lee Storrs. (Photo by Ellen Huber)

Years ago when Health Agent Linda Fantasia was hired, the late Gabor Miskolczy told her, “The Board of Health (BOH) does the business of the town.” What he meant, said Fantasia in an interview last week, was that the BOH is responsible for the oversight of the town’s water and environment, public health and preparedness, without all or any of which we would not have a place to live. 

Board Chair Bill Risso describes the BOH as “an arm of the state”—a vehicle through which the state can enforce its health regulations. Massachusetts is unusual: most states organize their BOHs around a county plan. According to Fantasia, the advantage of the Massachusetts plan is that each town or city gets the full attention of its BOH, and that is especially important in a town like Carlisle, which functions entirely on wells and septic systems. The downside is that at the state level, there is a lot more paperwork. 

At the state level, much of the work of public health is split between the Department of Environmental Protection (DEP) and the Department of Public Health (DPH). The DEP oversees environmental concerns like the protection of wetlands, plant and animal life, and potable water, and environmental contaminants like radon, mold, lead and asbestos and others, while the DPH deals with community health issues like communicable diseases, and crisis readiness. Municipal boards work with and report to both these state agencies.

BOH bailiwicks

Fantasia divides the work of the municipal boards of health into three main categories: Ppc health, environmental health and emergency preparedness, each with its separate, but often overlapping bailiwicks:

Public health responsibilities include community education about communicable diseases such as rabies, flu, tuberculosis, tick- and mosquito-borne diseases and others; home care and wellness; health clinics; disposal of special equipment and medicines; and animal health and safety regulations. 

The board helps protect environmental health through enforcement of state regulations governing septic systems and wells, protection of drinking water, noise control and licensing for food and water vendors and public kitchens. 

In the field of emergency preparedness, the BOH works with the Fire and Police Departments to plan for shelters and provide supplies for weather events or other emergencies. Supplies are currently stored in a trailer at Town Hall that was funded by Homeland Security. The board provides dispensaries, like the annual flu and rabies clinics, which   merge health and safety, and can be instituted in advance of or during a crisis. The board also works with other town officials and private citizens and groups (like ham radio operators) to enhance emergency communications capabilities town-wide.

Board of Health members bring varied backgrounds to the table

Fantasia emphasized that maintaining a highly effective BOH means bringing to the table members with varying backgrounds and areas of expertise and interest. Chair Bill Risso, for example, is a retired civil engineer, and says that his understanding of designs for septic systems, fire cisterns, as well as other components of construction and environmental planning and regulation helps the board to function in its capacity as the protective umbrella over water issues. 

Risso adds that Board Member Todd Thorsen has a background in chemistry that allows him to educate the board and the town when dealing with things like communicable diseases and water contaminants. 

Donna Margolies, a registered nurse with extensive experience in emergency room work, spoke of her interest in emergency preparedness, clinics and communicable diseases. She helps with BOH subcommittees like the Lyme Disease Subcommittee. 

Cathy Galligan is a project manager for an ongoing occupational safety and health research project at UMass Lowell, and came onto the BOH as a volunteer at a flu clinic. Because her research project was studying injuries associated with the use and disposal of medical sharps, she had a special interest in seeing how these pieces of equipment are used in a community setting. 

Fantasia emphasized that having a variety of skills and expertise has helped Carlisle’s BOH function very effectively on a limited budget. Members also say that having this variety of skills enables them to share the work and not become overwhelmed with a time commitment to the tasks.

BOH members enjoy community engagement

Each of the members of the Board of Health was quick to point out that one of the most rewarding aspects of working on the board is the chance to volunteer at occasions where they can engage the community first-hand: Old Home Day, the rabies and flu clinics, hazardous waste collection days and other events. Risso said that he gets great satisfaction from knowing that the work of the board helps individuals and the community at large. 

Galligan says that she also enjoys helping the work to be “transparent, and for stakeholders to better understand and have more control over their responsibilities. For example, the board has put together checklists for barn owners to self-certify their compliance with regulations and septic installers to prepare efficiently for mandatory inspections.” 

Sometimes, the board has to deal with the unexpected. Galligan says, “It continues to surprise me how often I have to quickly come up to speed on new topics… most recently the Zika virus.” Risso tells a story of a family that wished to exhume a body from the Green Cemetery in order to re-inter it in another cemetery. “The Board of Health has to sign off on that,” he said, and to do so, they have to research state and municipal regulations for exhumations, transporting, and re-burial. “This hasn’t come up before, and it’s more complicated than you’d expect, so we’re still working on that one.” All the members describe learning curves that challenge their intellects and expose them to interesting topics and people. 

Health challenges now and going forward

One of the issues currently facing the BOH is the rise in the nitrate level of the water at Gleason Public Library. Tests are ongoing to discover the source of the problem, and so far, the cause remains a mystery. However, the board hopes that new tests on ground water and runoff will help determine the cause. The library has followed regulations by prohibiting the public from drinking its tap water, providing bottled water instead. 

Another issue under current discussion is insect control. Mosquito-borne diseases are of increasing concern, and the board is researching environmentally safe ways to cut down the mosquito population, which, Risso says, “has reached epic and overwhelming proportions.” 

Galligan adds that getting the financial resources to perform many tasks that have been “pushed down from the state to communities” is an ongoing challenge. The BOH has consistently sought grants to help keep costs down. Interns, who help with studies, tracking and record keeping, are also important in keeping a lid on costs.

Keeping up with the increasing population also includes ensuring that emergency shelters and supplies keep pace with the number of people who need them. The Board of Selectmen and BOH have formed a shelter subcommittee to address this issue. 

Going forward, members agree that keeping Carlisle’s water supply safe is the single most important issue facing the town. With 40B developments increasing the number of people in a concentrated area, there are obvious effects on the  drinking water that have to be addressed. An ancillary issue connected to the uptick in population, says Fantasia, is community education. Water protection involves using safe cleaning products, for example, and the BOH hopes to help educate the public in making appropriate choices for all the products that interact with the water supply.

New member needed

The BOH has two openings for membership coming up in the Town Election, with one candidate, incumbent Cathy Galligan, running for one of the positions. People with an interest in public health, a desire to serve the town, a background that dovetails with the work of the board and/or skills in collaborative teamwork and a keen desire to learn are encouraged to run for the board. On the other side of the desk, so to speak, the public is always welcome at BOH meetings, and anyone with questions about anything pertaining to public health is encouraged to call the BOH office at 1-978-369-0283 for help.  ∆