Mutual aid may expand

It could mean that one town agrees to allow another community that has been struck with a medical emergency to use its skating rink as a temporary morgue. Or that health personnel in mutual aid towns help administer flu shots.

Several communities across the region are asking town meeting voters and city councils to approve a measure that will allow local health officials to enter into mutual aid agreements, just as fire and police departments have done for years. Health personnel in some communities are preparing to enthusiastically present the proposal to their voters, while others are taking a wait-and-see attitude due to concern over some financial aspects of the plan.

Under the agreement's provisions, mutual aid can take the form of expertise, personnel, or medical or other supplies. Shared services may include inspections, mass vaccination clinics, centers for the distribution of pharmaceuticals, administrative help, specimen collection and testing, and environmental assessment.

Communities that adopt the provision for mutual aid agree that they will consider requests for aid from other cities and towns whose resources have become overwhelmed, but they need provide aid only when they are able.

The state Department of Public Health has recommended that all communities put a provision before voters and city councils that would allow them to offer and receive mutual aid. In Scituate, health officials were staunchly behind the measure and voters approved it at last Saturday's annual Town Meeting. Jeanmarie Joyce, Hanover's health agent, hopes her community will follow suit in May.

''To me, this is basically formalizing what we are already doing now in small [communities] in Southeastern Massachusetts," Joyce said. It has long been Hanover's practice to cover in Rockland when that town's health agent is on vacation or out sick, Joyce said. And Rockland's health agent returns the favor. ''We also help out on things like inspections for summer carnivals when there are a lot of food vendors coming into one town," Joyce said.

If the mutual aid article is approved in May, Hanover's Board of Health can provide resources and personnel to other towns with which it has signed agreements. Most likely such arrangements will begin among towns in designated regions that have been set up by the state Department of Public Health for emergency preparedness. Hanover's Region 4B consists of communities that lie within a crescent-shaped area around Boston. Bordering towns that don't fall into the 4B region -- such as Rockland -- also will be among Hanover's mutual aid connections, Joyce said.

One of the agreement's provisions that has caused some concern is the requirement that the sending town remains responsible for the wages, benefits, and other obligations related to its employees and is responsible for any liability those employees incur while giving aid. There also remains some confusion as to what approval of the memorandum actually means. Some health agents say they don't know whether their towns are agreeing to share mutual aid with other communities in their region, or are agreeing to provide aid throughout the state.

''I think we need to take some time to review this," said Alan Perry, Raynham's health agent, who added that no date has been set to place the mutual aid proposal before voters. Perry said he and some other officials in Region 5 would rather take a year to see the details of the mutual aid plan refined. Health officials in a coalition of 24 towns within Region 5 have been meeting monthly, Perry said, and the mutual aid proposal has come up.

''We've discussed it, but there are still too many questions," Perry said. ''We'd like to see some things ironed out, so we'll wait to see what happens in other communities."

Perry said he is in favor of mutual aid, and he believes the spirit of cooperation is already evident among health officials in Region 5. ''If there was an emergency, I know they would help each other out," he said.

Plymouth Health Director Susan Merrifield said Town Meeting will not be asked to consider mutual aid this spring. ''Mutual aid is an important part of the homeland security program, but we're working on other, more pressing issues," Merrifield said. ''We have to make sure we have a continuity of operations plan in place so we have people to step in and run basic services in an emergency. And we're still getting volunteers for the town's 11 dispensing sites in the event of an outbreak like small pox. Plymouth is also in the process of putting together information for families on how to prepare for a flu pandemic."

Stanley Kravitz, health agent in Bridgewater, said the memorandum for mutual aid will be placed before the town's voters this fall. ''We're great supporters of it," Kravitz said. ''There are some bugs in it, but that's fine; they will be worked out. Health departments are small compared to the populations we serve. Together we can get better expertise than we ever could individually."

Milton Health Director Michael Blanchard said the town's Board of Health had not finished discussing the mutual aid proposal in time to get it on the warrant for this spring's annual Town Meeting, so it will go to the voting public this fall. ''The Board of Health gives it its full support," Blanchard said.

Cathleen Drinan, health agent in Halifax and another supporter of mutual aid, said the article has been included on the annual Town Meeting warrant in May, but she acknowledges that it could be a tough sell because of the provision that the sending town pay the expenses and incur the liability. ''But we'll say we don't respond if the town can't afford it," Drinan said. ''It doesn't necessarily mean the town will incur any more costs."

Blanchard said it's standard in mutual aid agreements for the sending town to pay the expense. He argued that it balances out if all towns agree to the same terms. ''Your town will pay while you're there, and it's also vice versa. It works both ways," he said.

Hingham's executive health officer, Bruce Capman, said the mutual aid agreement will formalize an arrangement that health departments have used for years, ''so everybody is on the same page." And once agreements are in place, towns may qualify for some financial reimbursement for the help they provide under homeland security, Capman said. ''I'm surprised anybody is upset with this," Capman said. ''What I'm hearing in my region is, 'It's about time.' "

Christine Wallgren can be reached at CLWallgren@aol.com.