In a recent conversation, Jenna Montgomery, public health educator and communications specialist with Nashoba Associated Boards of Health (NABH), talked enthusiastically about “being back.” She said public health services have “been in a hole” the past few years during the pandemic, and she is happy to be out in the communities, giving presentations and reintroducing people to the services provided to 16 towns by NABH division of public health nursing.
Montgomery, who has been with the agency for two years, said she is having so much fun in her job, meeting many interesting people living in the communities NABH serves and those working in a variety of town offices. “The towns are very different, and I’ve learned new things,” she said, among them what Title 5 is.
She’s enjoyed creating trivia for her informational presentation by exploring the archives at NABH’s renovated offices at 30 Central Avenue in Ayer, such as that the agency was established in 1931. Perhaps it is no surprise that Massachusetts created the first sustained board of health but somewhat incongruous that Paul Revere was the first ever chairperson of a board of health in America.
Montgomery explained that NABH operates in partnership with local boards of health, carrying out daily work on behalf of the boards. There is no cost to residents; the services are part of local taxes. The agency has an environmental division that addresses public health and environmental concerns. For most of Harvard’s homeowners, this means issues of compliance with codes governing septic systems (Title 5) and wells.
Jenna Montgomery of the Nashoba Associated Boards of Health at the Council on Aging Open House, Oct. 4. (Photo by Lisa Aciukewicz)
Disease prevention and education
Residents may be less familiar with the other half of NABH, the public health nursing division. The mission of this division is “to promote wellness across the lifespan in our 16 member communities.” The nurses’ work is focused not on treatment but on disease prevention and identification and on education. For most of the 20th century, Harvard’s town nurse was a woman who lived in town and visited sick people in their homes. Presently, the three-member staff of the public health nursing division are considered the “town nurse” and are available for consultation every weekday. Montgomery said community health manager Tamara Bedard has been an R.N. for 26 years and is a “powerhouse” whose “heart is in her work.”
A major role of public health nurses is communicable disease investigation. If a person’s lab work shows a reportable disease, such as Lyme, salmonella, or tuberculosis, that information is kept confidential among certain officials, including the public health nurse. The nurse reaches out to the sick person to get more information, seeing how they are feeling and trying to identify how the person may have contracted the disease. Sometimes a food recall or restaurant closure may be instituted, based on the nurse’s information. Sometimes an insect or water may be a suspected source of illness, and the nurse would report that to the appropriate officials. During a disease outbreak, such as COVID-19, the nurse will do contact tracing.
The public health nursing division holds monthly well-adult clinics, usually at a senior center (Harvard’s is the third Tuesday of the month 12:30 to 1:30 p.m.). A resident may have a blood pressure check, a health screening, talk with a nurse for advice and resources, or get help organizing medications. The public health nursing division also holds seasonal flu vaccination clinics. A schedule is available at nashoba.org/schedule. While the public health nurses do not do home visits for hands-on care, they will do a flu vaccination for a homebound resident, evaluate a living environment for health and safety, partner for a home visit with elder protective services, be “the glue” of a support team, and provide education. It is amazing how a public health nurse can “pull resources out of the air,” said Montgomery.
Part of Montgomery’s job is to present educational programs. In addition to the one on the resources available through nursing services of NABH, she has talked about heart health and emergency preparedness for disabled persons. She is aware of what social determinants can affect health and said that loneliness literally “rots our brain.” The pandemic brought isolation to the fore and showed how severe the problem of loneliness is across the country. She said well-adult clinics can help with loneliness, along with outreach from a council on aging.
Mental health and support services
“Everything connects to public health,” said Montgomery. In addition to her degree in clinical social work and her work at a community mental health center, Montgomery spent three years working with patients at a psychiatric clinic. This background made her a knowledgeable partner to work with Nashoba Valley Medical Center in bringing in trainees for a certification program in mental health first aid. She said in talking to Harvard Police Chief James Babu, he reported that all his officers had been certified.
Montgomery has a connection with Kristin Normandin, the co-response clinician from the nonprofit agency Advocates, who works with Harvard and Stow police departments. Montgomery said it gives peace of mind to a police department to have someone clinically trained in mental health and behavioral crises to partner with in keeping the community safe. She said the program has resulted in fewer hospitalizations and reduced liability.
Montgomery is teaming with Bedard to offer a trial grief and bereavement program. They have a grant to bring in a counselor, and the group will meet at the Harvard Senior Center starting Nov. 23 at 2 p.m. and continue to meet the second Monday of each month. Nashoba Nursing Service and Hospice, which used to be part of NABH, closed last summer for staffing and financial reasons, and Montgomery and Bedard advocated for continuing the grief program it had offered.
Residents may call the town nurse with concerns about someone of any age who is at risk and may need additional services, for assistance with coordinating care, for possible hoarding issues, and for communicable disease follow-up. The message from the NABH public health nursing division is, “When in doubt, call.” The number is 978-772-3335, and if they don’t have the answer, they can point a caller in the right direction.
