Charles River shared-services review: environmental public health strong, maternal‑child services lag

Manizae Afridi, a consultant with BME Strategies, and state public‑health staff presented preliminary fiscal‑year 2024 results from the Foundation for Public Health Services (FPHS) shared‑services review for the Charles River Public Health District, a four‑jurisdiction collaboration of Dover, Medfield, Needham and Sherburne.

The presenters said the shared‑service arrangement spent about $2,840,000 in FY2024; $2,780,000 of that was reported as spending specifically on foundational public health services. Manizae Afridi said 36.7% of that spending “came from grant dollars,” that the arrangement received eight grants in the year and that $54,500 was spent on community‑specific services. The group’s regional staff categories included office and administrative support, behavioral health, environmental health, registered nurse training hub staff and a shared‑services coordinator, the presentation said.

The FPHS framework, the presenters said, distinguishes foundational areas (core programs) and foundational capabilities (skills and functions that support programs). Jessica Furlant, program coordinator at the Massachusetts Department of Public Health, and Christina Moore, an epidemiologist at the Office of Local and Regional Health, joined the presentation and discussion.

Why it matters: the FPHS framework is the state’s working baseline for what public health should ensure is available locally. The preliminary data are intended to help the district set priorities and identify where to invest in shared staff, trainings or partnerships to meet state performance expectations.

Key findings and context: presenters highlighted that the highest shares of spending and staff time were in organizational competencies and environmental public health. The slide deck showed local public‑health entities in the district dedicated 14.2% of total spending and 15.8% of staff working hours to environmental public health. Manizae Afridi summarized that most communities in the arrangement reported that environmental public‑health needs were being met and recommended leveraging shared‑staff expertise for targeted trainings and knowledge sharing.

By contrast, maternal, child and family health accounted for 0.8% of total spending and 0.4% of staff hours in the FY2024 data. The presenters’ charts showed most local entities indicating that community needs for maternal, child and family health were not met. The presentation recommended exploring partnerships with other municipal departments and regional groups and suggested using community health needs assessments or partner mapping to clarify demand before creating new programs.

Members of the district raised questions about how behavioral‑health work is represented in the FPHS structure. Kaye Peterson asked why the presentation did not show behavioral health as a separate foundational public‑health service; Manizae Afridi responded that behavioral‑health staff fall into occupation categories but that behavioral health is not a separate FPHS foundational area and that behavioral‑health work can sit under services such as access to clinical care or chronic‑disease prevention.

Several members requested municipal‑level data. Daryl Beardsley and others asked whether each town could receive its own dataset so local officials can compare municipal results with the shared‑service averages; Manizae and the state team said municipal reports are available on request and urged members to request them by contacting the presenters.

Presenters emphasized the preliminary and point‑in‑time nature of the dataset. “The data that I’m presenting back to you today is from fiscal year 20 24,” Manizae said during the presentation to underline that staffing or program changes after that fiscal year would not be reflected. The presenters also noted that the data are not evaluative measures of performance but tools to support planning and shared‑service decisions.

Next steps and resources: the presenters described a “data‑to‑action” toolkit available in Smartsheet, including an FPHS work plan crosswalk, a partner‑mapping template and a discussion facilitation guide, and offered follow‑up data requests and support from OLRH and MHOA subject‑matter experts. Members were encouraged to use municipal reports to inform local requests for staffing or funding.

Ending: the group agreed to review the municipal reports and to use the FPHS findings as one input into FY2026 work‑plan decisions and training priorities.