Officials weigh mutual aid pact
By Katheleen Conti, Globe Staff | May 18, 2006
Four area communities are considering joining 23 other Boston suburbs in a public-health mutual aid effort that was conceived two years ago after a hepatitis A outbreak in an Arlington restaurant.
Overwhelmed when about 3,000 residents waited for inoculation after the outbreak, Arlington’s health director reached out to her counterparts in neighboring communities for assistance. The incident spawned the formation of a voluntary alliance among area public health department officials, who are now seeking a formal relationship similar to the mutual aid initiatives used by public safety officials.
On May 8, the Revere City Council unanimously accepted the mutual aid agreement, officially consenting to share public health resources on an as-needed basis with the other communities in its designated region.

”If you were to have an epidemic of hepatitis A right now, in some towns they’re not equipped to handle it, and it doesn’t make sense to have a large staff on payroll just waiting for an epidemic to happen,” said Ward 5 Councilor John Powers, who leads the Revere council’s public safety subcommittee. ”So what this is, is a consortium among towns. In Arlington, they had an outbreak of hepatitis A, and if that were to happen in Revere, we can draw assistance from any of these cities and towns.”
Chelsea, Everett, and Winthrop are among the communities reviewing the proposal.
”The public health mutual aid agreement is an effort to emulate what fire and police benefit from right now, which is the benefit of going into other jurisdictions to offer help,” said Kerry C. Dunnell, local government liaison for the Cambridge Public Health Department’s Advanced Practice Center for Emergency Preparedness. ”Communities have known there was no way for public health departments to do that.”
Cambridge is the host city for Emergency Preparedness Region 4B, which comprises 27 communities from Winthrop to Hull in a crescent around Boston. The communities have a combined population of 980,000, according to 2000 US Census numbers. Boston, which is its own designated region, recently agreed to also help out 4B communities, Dunnell said.
Communities in Region 4B, which was formed by the state in 2002 for emergency planning purposes, have worked together to discuss such issues as West Nile virus mosquito spraying, anthrax, and tobacco control, Dunnell said.
Under the mutual aid agreement, the health director in a community with a crisis situation would contact the Cambridge-based 4B regional coordinator, who would contact the 26 other communities for help.
Every community in Region 4B was given a template of the mutual agreement for consideration by their governing bodies, Dunnell said, and about 14 have approved taking part in the arrangement. Because the issue was not included on the annual Town Meeting warrants in some communities this spring, the process could stretch out until after the fall Town Meeting season, she said.
In Chelsea, officials are still reviewing the language in the mutual aid agreement, said its Health Department director, Luis Prado. Once it is reviewed by the city solicitor, Prado said, it will be forwarded to the city manager, the Board of Health, and the City Council. Prado doesn’t expect city officials to vote on it for another couple of months, but said he is in favor of it.
”This is a trend that is soon to be very useful and important in the future,” he said.
Prado added that while the avian flu has been grabbing attention recently, the mutual aid agreement should not raise concerns about an impending crisis. Coordinated emergency planning can include everything from a major health emergency to regional flu shot clinics.
”There are situations where you have, for example, a hepatitis A outbreak, or there is a need for developing some campaign of education around issues like West Nile virus, or a need to coordinate mosquito control on a regional basis,” Prado said. ”If you have agreements in place, it simplifies communications between cities and towns. The accessibility of resources is what is interesting.”
In Everett, a change in administration and the absence of a public health director until last week have kept the issue on hold, Dunnell said.
In Winthrop, health officials met with Dunnell last week to discuss the package and prepare it for review. W. Paul Frazier, Winthrop’s public health director, said he is getting ready to send copies of the package to the town manager and the Town Council.
”I think it would be a great benefit for the town of Winthrop,” Frazier said. ”It’s so small, but we have so much to offer others and others have much to offer us in the case of a disaster.”
Dunnell said she hoped to have ”tabletop exercises” soon with the communities willing to join mutual aid to talk about how they would respond to different health scenarios.
”We’ve actually started experimenting with regional vaccinations of flu when we had the shortage two years ago,” Dunnell said. She added that she would like discussions to evolve into drills that would allow communities to practice responding to emergency situations. ”I think it would be wonderful to have an opportunity to play it out.”
Dunnell said that mutual aid among public health departments is so new that there are still some details that need to be worked through. She said it is a large step for communities to realize that health issues don’t stop at their borders.
”This is an opportunity for communities . . . to recognize that residents of that community don’t just eat at the restaurants of that community or swim at the pools of that community,” Dunnell said. ”People pass through other towns.”
Katheleen Conti can be reached at kconti@globe.com.