WESTFORD CENTER — The Board of Health works alongside the town’s Health Department, which handles inspections, permitting and day-to-day enforcement. The board itself focuses on policy, regulation and decision-making, often weighing complex issues that affect both individual residents and the broader community.
Chair Stephanie Granger said the scope of the board’s authority, and the reasoning behind its decisions, is not always fully understood by the public. In a recent interview, she discussed the board’s responsibilities, how it approaches difficult decisions and the challenges shaping public health today.
Q: What is the primary role of the Board of Health, and what do residents most often misunderstand about its authority?
A: The Board of Health is an elected body responsible for developing policies and regulations and enforcing local and state health and sanitary codes. The Board is charged with protecting the public health and safety of the town and directs the Health Department to carry out enforcement. The most significant misunderstanding is that local boards of health are acting beyond their scope, when they are, in fact, exercising delegated, legally mandated authority to protect public health, often with strong judicial backing
Q: What types of public health issues most commonly come before the board, and which require the most deliberation?
A: The most common issues that the Board of Health addresses are septic and well variances, regulation updates, new regulations, public health violations, and housing cases. Updating our regulations or writing new regulations probably requires the most deliberation. Some variance requests for wells or septic systems require more deliberation than others, depending on the complexity and degree of variance requested.
Q: How does the board balance public health protection with individual rights and personal freedoms?
A: The Board of Health has broad authority when working to protect the public health but it is important to consider the impact to personal freedom. The responsibility of the board is to weigh the impact of the situation based on the facts and circumstances known to the board at the time a decision is made. Our responsibility is to determine and act in ways that protect the public health and safety. It is not something that we take lightly and I truly believe that all of the board members, with whom I have had the privilege to work, really do their best to consider this when considering regulations and other decisions.
Q: What laws, regulations or state guidance most strongly shape the board’s decisions?
A: There are a multitude of MGL’s, Federal, State , and Local laws, regulations, and statutes that directly guide the Board of Health and Health Department’s decisions. When we need guidance we can talk with our Health Director or the Massachusetts Association of Health Boards or town legal counsel.
Q: How does the board respond to emerging public health concerns, such as disease outbreaks or environmental hazards?
A: The board tries to stay abreast of emerging public health concerns and listens to the health director who is aware of problems the town is seeing or that the state is alerting them to. As we receive information about concerns we do our own research, seek guidance from the Massachusetts Association of Health Boards and State Department of Public Health and other public health agencies then discuss possible responses in meetings to form a response.
Q: What role does the board play in areas like housing conditions, septic systems and environmental health?
A: The board plays a role in these public health issues by reviewing and voting on cases, variance requests, proposed plans, violations, fines, closures if needed, condemnations, and regulations. It is the Health Department that handles the day-to-day operations, implementation of enforcement, approvals and inspections.
Q: How does the board use data, inspections and expert input to inform its decisions?
A: Board members review data, peer reviewed research, statistics, metrics, and valid resources and expert opinions in order to make informed decisions. I frequently perform literature reviews, seek out and talk with experts, read studies and look at the available data prior to meetings so that I am prepared and well versed in the topic we will be discussing in our meeting. We also invite experts to our meetings to discuss issues with the board.
Q: How does the board work with local health agents, town staff and state agencies?
A: We work closely with town staff, departments, boards, committees, partners, industry, academia, state, and federal partners every day. These relationships are vital to our public health work.
Q: What enforcement tools does the board have when regulations are not followed?
A: When regulations are not followed we try to make sure that we are providing education on the topic and offer more, other tools include fines, closures, condemnation and court.
Q: How does public input factor into decisions, and when is it most effective?
A: It’s important for residents to know that they can attend a board meeting, email or call with questions, concerns or opinions. Their input is very important to decisions. However, there are situations where we need to follow the federal or state regulation or make decisions based on the data and interest of the overall public health.
Q: What are some of the most challenging or contentious decisions the board has faced?
A: Since I have been on the board the biggest challenge we have faced was the pandemic. During this time we met weekly as a board and I, as chair, was in daily contact with the health director. We worked closely with state and other town boards to make sure we were doing the best we could with the available data and constantly changing circumstances. During this time of constant change the Health Department staff were overwhelmed with daily and weekly changes, contact tracing, enforcement, regulatory oversight, staff capacity, isolation and quarantine. Another big issue of concern when I first joined the board was the proposed asphalt plant and all the public health concerns, regulation and oversight issues that entailed. During such times we try to remain focused on protecting public health for all.
Q: How does the board address health equity and support vulnerable populations?
A: The board tries to make sure our regulations and efforts address social determinants of health. We work to focus on root causes of inequity, such as food insecurity, housing, and transportation, by providing resources and support to vulnerable populations.
Q: What long-term public health challenges is the board preparing for?
A: Public Health is always changing as new challenges such as increased drought seasons, climate change, PFAS, youth gambling, new body art proposals, and new products that pose health risks come to market. We are continually updating regulations or creating new ones. We are working with the department to make sure that through their strategic plan they are poised to manage these changes.
Q: What should residents know before starting projects that may require Board of Health approval?
A: The Health Department recommends making an appointment, calling, or sending an email before you start your project or file for a building permit. The department is a sign-off on building permits. They check to make sure your renovation is not going to impact any important components such as your septic system or well. There are set back requirements for a renovation to these components. The Health Department also checks these setbacks for you. The state has Title 5 requirements that govern private septic systems and wells. The department reviews your existing and proposed plans for your system and looks at the bedroom count. This pre-review helps make the process easier for the resident. It helps avoid hiccups in the process.
Q: For residents interested in serving on the Board of Health, what commitment or expertise is helpful?
A: Board of Health meetings are on the second Monday of each month. Board members review the meeting packet each month and should be present and ready to participate at meetings. Board members also support the Health Department director and staff when needed, be present at community events and town meetings when needed. Expertise in public health, medical, or environmental health is preferred but not required.
