Swampscott is set to not have a public health nurse as of July 1. 

Through budgetary discussions, it was decided to remove the public health nurse position as part of an effort to reduce the town’s annual budget. Following the Town Meeting vote last month to approve the proposed budget, the public health nurse was officially put at risk. The Board of Health, however, suggests they were blindsided.

“The Board of Health didn’t know about this,” Board of Health Member Lawrence Block said. “We’ve got a human, who’s done an amazing job. I don’t get it.”

Select Board Chair Katie Phelan joined the Board of Health in a meeting last week. She told the board that “through the budget process, there were conversations about cuts to a myriad of potential individual departments.”  Phelan said nothing has been communicated yet with the current public health nurse, Neia Illingworth.

At the time, some staff members were not informed that their positions could potentially be eliminated. That is why there was no budget line set to zero because “we would never tell a staff member through a budget conversation that their position may potentially be cut,” according to Phelan. Phelan said the money was supposed to be “offset by the salary reserve.”

“That commentary was made, and I asked again…a few weeks ago,” Phelan said. “It’s not exactly that it got funded and then got lost. It was intended at the time of funding to be funded.”

Phelan said that there were conversations around multiple departments, not just specifically the health department. She did say she does not believe there was an open vote about the topic.

“In the end Gino (Cresta) creates a budget that he feels supported by the board and he made the suggestion that this particular line item be reduced and that the salary reserve be reduced by that amount,” Phelan said.

Director of Public Health Jeffrey Vaughan read part of a 13-page description of the responsibilities of the public health nurse, including case assessment, investigations into exposure, implementing treatment plans and social services. 

“I’m not exactly sure how you can subtract all of this into a non-position,” Vaughan said. “I’m beyond shortsighted in this. Beyond whatever the financial implications are, this can be done.”

Gargi Cooper, the chair of the Board of Health, expressed concern about the lack of a public health nurse, particularly in the aftermath of the COVID-19 pandemic.

“I realize that fiscally, there are a lot of concerns in our budget,” Cooper said. “We did look at core functions of the public health position, and we want to make sure that they’re being examined thoroughly and how it impacts obviously our community but also the school system because I know they rely on the public health nurse…A town like Swampscott, we need a nurse to carry out the functions of the state regulations.”

A registered nurse is required to comply locally with the state regulations, Cooper said.

Cooper also asked to speak with interim Town Administrator Gino Cresta about the issue. She also told Illingworth after an update on Swampscott’s health that “we’re going to advocate” for her position.

“We appreciate you and all of your work,” Cooper said. “This feels very unacceptable.”

Block suggested that if the budget line had been clearly discussed before Town Meeting, the Board of Health could have weighed in, and the town would have been better informed about the implications of their vote.

“People want health,” Block said.

Several community and regional members voiced their opposition to the elimination fo the position at the June 18 Select Board meeting. Former long-time resident of Swampscott David Greenbaum, who is the health agent in Salem, spoke out.

“I believe this position is of the utmost importance in any community,” Greenbaum said. “Eliminating a position of this importance would be a detriment to the town of Swampscott, and I think that the town really needs to take a long look at what this position does.” 

Sharon Cameron, the director of health in Peabody, also spoke at the meeting about how the town’s health is “intertwined with the health of the region.” She mentioned how if a resident of Swampscott is handling food as part of their job in Peabody, that disease would be able to spread to multiple communities then.

“One of the cliches of public health is that diseases don’t respect municipal borders,” Cameron said. “Collaboration between our regional health departments, especially our public health nurses, is essential to keeping all our residents safe.”

Phelan told the Board of Health that the senior center also reached out to her about “what a detriment the loss of a public health nurse would be.”

“I think there are a lot of conversations still to be had in the near future,” Phelan said. “We asked for a list of all the core functions, what would be lacking, if the public health nurse could be part time, if it could be a shared service, if we could regionalize public health between Nahant and Marblehead. There were a lot of ideas on the table for some cost savings that wouldn’t leave a gap for the community members…If there’s something to be done, I will advocate on your behalf.”