At the local level, boards of health have the primary responsibility for protecting public health in Massachusetts. Under state law, the selectmen act as the board of health, if the town has no other arrangement. G.L.c.41, §1. Selectmen also can be authorized by town meeting to appoint a board of health. G.L.c.41, §121. More often, towns decide to have a separate board of health consisting of three or more elected members. It is not widely appreciate that the board of health may be the most powerful land use control and environmental protection agency in town hall.

We would welcome your inquiry about our interest, availability and qualifications to help you with a board of health matter.

Members of boards of health are not required by law to have any medical or health training, although in practice many do. A board may appoint a physician and other staff, however, to advise and assist them. G.L. c.111, §27.

In those towns in which the selectmen serve as the board of health, the field has become so complex that professional assistance is practically a necessity. Selectmen are authorized, by law, to appoint a health inspector, and in towns of less than 3,000 people, that person maybe the school physician. G.L. c.41, §§102, 102A and 102B. Most towns employ a health inspector and a public health nurse, either full-time, part-time, or on a contract basis. Qualifications for a health inspector include licensure as a registered sanitarian (R.S.). Many towns also require that inspectors be certified health officers (C.H.O.).

Several groups of towns have elected to form regional health districts. G.L. c.111, §26A. Some towns specify in their home rule charters a different method of delegating health duties. G.L. c.43B, §20.

Boards of health have a wide range of responsibilities and functions specified by state law.
Among the board's specific legal duties is enforcement of the State Sanitary Code, which establishes standards for day camps, swimming pools, and food service establishments. G.L. c.111, §127A. The code permits a board of health or other health authority to adopt rules and regulations stricter than those contained in the code.

Boards of health are also the local enforcement agents for the State Environmental Code, Title 5 of which establishes minimum standards for sewage disposal. Local boards of health may adopt more stringent regulations as local conditions warrant.

Boards of health may issue orders declaring that an emergency exists and requiring that certain actions be taken. This is very broad authority going back centuries to colonial times. More modern statutory authority provides that boards of health have extensive power to adopt and enforce any reasonable health regulation. G.L. c.111, §31. Using their nuisance abatement power, boards of health are authorized to examine all nuisances which may be injurious to the public health and to destroy, remove, or prevent them. Orders issued to this effect may be called nuisance abatement orders. G.L. c.111, §122. A separate section of law gives selectmen the same nuisance abatement powers as boards of health. G.L. c.139, §3.  Some towns have nuisance bylaws allowing officials to clean up a nuisance, bill the property owner for costs, and place a lien on the property if the bill is not paid.

Under specialized statutes, boards of health may order the fluoridation of water supplies, adopt and enforce local regulations for the control of air pollution, and regulate animal stables.

State law permits boards of health, or selectmen acting as boards of health, to establish and maintain dental, medical, and health clinics and to conduct general education campaigns relating to health matters. G.L. c.111, §50. Many of these direct health services departments are aimed at adults and children who are unable to obtain private medical care. Many towns now provide flu vaccination clinics, well-baby clinics, hypertension screening, and screening for blood lead poisoning, among other community health services.

The local health authority is required to notify the state Department of Public Health within 24 hours of the discovery of a case of a communicable disease. G.L. c.111, §§112 and 113. Every board is required to appoint a person (who may be a board member) to maintain a record of diseases. The board of health must notify the school committee of all reported diseases that are dangerous to the public health.

Boards of health have broad authority to regulate in environmental areas where there is a risk of adverse health consequences. Among other things, boards of health have the power to enforce state laws and regulations concerning groundwater monitoring, septic systems, underground fuel and chemical storage, landfills, incinerators and transfer stations, hazardous waste, and water supply contamination. The board of health may make and enforce regulations concerning house drainage and connection with common sewers. G.L. c.111, §127.

Boards of health and selectmen have the comparable authority to take action in the removal of nuisances. A health nuisance is defined by law as a source of filth or a cause of sickness. State law gives the board of health the power, to approve a business that may result in a nuisance or harm to the inhabitants, cause injury to their land, or cause offensive or dangerous odors. This permission is called a noisome trade site assignment. G.L. c. 111, §143.

Selectmen may declare a burned, dilapidated, or dangerous building, structure, or vacant lot to be a nuisance. After holding a public hearing and giving written notice to the owner of the property or his authorized agent, the selectmen may order the nuisance altered, disposed of, or regulated. If the owner fails to comply, the town can sue for the cost of removing the building or for the cost of another solution. G.L. c.139, §§1, 3A.

We are as familiar with the rights and duties as well as procedures and legal principles of boards of health as we are of conservation commissions, zoning boards of appeal, planning boards, boards of selectmen,  building inspectors, and other officials controlling the use of real property and protection of the public health and safety.