A participatory approach to planning for regional public health services in Massachusetts

Massachusetts has 351 jurisdictions, each with its own board of health responsible for assuring access to an identical set of services. Faced with a myriad of funding and workforce challenges, most municipalities are currently unable to meet many of their basic public health responsibilities. To address inequalities in the breadth and quality of public health services, the Massachusetts Public Health Regionalization Project (MAPHRP) was formed to develop recommendations for regional systems. In 2008, the MAPHRP received funding from the RWJF to create a Practice Based Research Network (PBRN) that would bring local and state public health practitioners, municipal leaders and academics together to identify research interests that further regional service delivery planning and implementation. This paper reports on findings from our first study, conducted in partnership with three groups of communities (N=18) who were interested in forming regional public health systems. In this study we asked the following questions: 1) What information do local communities need to make decisions about reorganizing public health services? 2) What process best facilitates the shift from a local to a regional service delivery model? 3) How does a local community decide which regional model is the best fit? 4) How do we encourage local governing bodies to embrace the comprehensive responsibilities of a 21st century public health department? The presentation will focus on the collaborative assessment strategies we used to answer these questions and will conclude with an overview of recommendations that were put together for local municipalities interested in public health regionalization.